Correction: Illinois Medicaid-Overpayments story
Apr. 22, 2014
CHICAGO (AP) — In a story April 19 about Illinois Gov. Pat Quinn promising tighter controls after a review found the state's Medicaid program paid an estimated $12 million for services for people who had already died, The Associated Press erroneously reported that the state's contract with Maximus Health Services ended last year. The state continues to have a contract with Maximus for some services, but effective May 1, state employees will work with the company to verify Medicaid eligibility.
A corrected version of the story is below:
Quinn: New controls after Medicaid paid for dead
Quinn promises better controls after review finds Illinois Medicaid paid $12M for dead clients
By JASON KEYSER
CHICAGO (AP) — Gov. Pat Quinn promised tighter controls Saturday after a review found that the Illinois Medicaid program paid an estimated $12 million for medical services for people who had already died.
The Democratic governor told reporters he's not happy with the findings and the state is on track to get back all of the money.
"We've already recouped a great deal of the money," Quinn said. "We intend to get every single penny."
Republican lawmakers seized on the mistake as evidence that Illinois' Democratic leadership has failed to do all it can to clean up the Medicaid rolls and shield the system from abuse. The error emerged during one of the most hotly contested governor's races in the nation and could become an issue in the campaign.
When asked about the matter Saturday, a spokesman for Quinn's Republican opponent, wealthy businessman Bruce Rauner, said it warranted further scrutiny and was "another troubling sign pointing towards Pat Quinn's inability to run state government."
The Associated Press learned of the mistake from an internal state government memo it obtained Friday through the Freedom of Information Act.
The memo says the state auditor compared clients enrolled in the Medicaid database last June with state death records dating back to 1970. Auditors identified overpayments for services to roughly 2,900 people after the date of their deaths.
Quinn said Saturday that in most of the cases, managed care insurance companies had improperly billed the state for those people.
"When we discover this we get the money back from those insurance companies," he said.
The memo states that more than $7 million has been recovered and the rest is expected to be recouped by year's end.
It was written by the directors of the departments of Healthcare and Family Services and Human Services, the two state agencies involved with Medicaid payments, and is addressed to their senior staff members.
In the document, they outline steps to fix the problem.
Quinn, speaking to reporters after an unrelated event in Chicago, said the goal is "zero tolerance for any kind of mistake."
"We have to put in even tighter controls," he said. "... The important thing is to recoup every dollar for the taxpayers. We're doing exactly that."
Republicans have pressed for the state to use a private company to verify Medicaid eligibility. Maximus Health Services was hired to scrub state Medicaid rolls following 2012 Medicaid-reform legislation. Republicans have said the company was achieving a Medicaid eligibility-removal rate of 40 percent.
But the state's largest public-employee union objected to the work being outsourced, and an arbitrator sided with the union last year. Effective May 1, state employees will work with Maximus to verify eligibility.
Republicans wanted Quinn to appeal the ruling. They have repeatedly said better verification of eligibility and rooting out fraud and abuse could help save the cash-strapped state much-needed funds. Republicans say that in light of the findings they will renew that push.
Quinn said he favored sticking with the state's own verification work.
"We're doing that right now," he said. "We have everything in place to identify anything, anybody, any practice that isn't proper."
Associated Press writer Kerry Lester in Springfield, Ill., contributed to this report.