Friday, October 19, 2012
Springfield, Ill. – An annual audit of the state’s taxpayer-financed All Kids health insurance program shows the departments in charge of administering the program continue to struggle to implement previous audit recommendations, according to State Sen. Ron Sandack (R-Downers Grove).
In other state news, Gov. Pat Quinn’s decision to award one of six coordinated care contracts to a politically-connected firm is raising questions and concerns among advocates for nursing home residents, according to the Associated Press. And for some Illinois inmates, committing crime outside prison walls isn’t enough—according to the Illinois Department of Employment Security (IDES), many have illegally collected nearly $2 million in unemployment insurance claims while serving their sentences.
According to the Auditor General’s office, a yearly review of the All Kids program showed ongoing internal administrative issues relating to eligibility determination, documentation of immigrants, nonpayment of premiums, data collection, and more.
Audit findings show the Department of Healthcare and Family Services (HFS) and the Department of Human Services (DHS) have failed to address situations wherein:
• In Fiscal Year 2010, 414 individuals received 2,543 services totaling $126,092 after the month of their 19th birthday, at which point they were not eligible for coverage. HFS and DHS are currently working to implement an eligibility system to improve the accuracy with which they make eligibility determinations and redeterminations.
• In Fiscal Year 2011, 315 individuals appeared to be enrolled with more than one identification number.
• HFS continued to incorrectly categorize “documented immigrants” as “undocumented.” Because the Department incorrectly classified 11,130 enrollees with Social Security numbers as “undocumented,” the state did not submit or receive federal matching funds for these misclassified documented immigrants. In Fiscal Year 2010 and 2011, undocumented immigrants made up 65 percent of the total payments for the expanded All Kids program.
• HFS failed to terminate All Kids coverage when enrollees failed to pay premiums on time.
• A previous audit showing ineffective controls of optical claims resulted in optical providers billing for multiple frames and fittings for the same recipient during the year. In one case, a provider billed for 180 frames and 186 fittings for 41 recipients in one fiscal year. HFS is still working to address this situation.
The Auditor noted that HFS and DHS did incorporate previous audit recommendations targeting All Kids policies and procedures. The departments’ changes were found to have reduced confusion, and addressed instances of conflicting or duplicative information and directions.
According to the Auditor General’s report, in Fiscal Year 2011 more than 97,000 kids were enrolled in the expanded All Kids program instituted by Gov. Rod Blagojevich and legislative Democrats. The program serves uninsured children who were not covered by the state’s previous KidCare program, extending health insurance benefits to children whose family income exceeds 200 percent of the federal poverty level or who are undocumented immigrants.
In other news, Illinois convicts hauled in $2 million from fraudulent unemployment insurance claims while behind bars.
According to IDES, more than 1,100 prisoners have fraudulently claimed unemployment benefits during the last two years. The agency discovered the fraud by comparing lists of individuals collecting unemployment benefits with inmate rosters from the Illinois prison system.
The worst offender was a prisoner in the Cook County Jail who collected a whopping $43,000 in bogus benefits.
Fortunately for taxpayers, the inmates involved in the fraud will be required to pay back the $2 million, and could face additional jail time if convicted in the schemes.
Unemployment fraud isn’t limited to those behind bars, however. During the past year, the state has targeted tens of thousands of people who’ve collected about $120 million in wrongful unemployment claims. Those fraudsters must agree to a repayment plan, or else face garnishment of their federal and state taxes until the money is recovered.
Gov. Quinn’s decision to award one of six coordinated care contracts to a politically-connected firm is raising questions and concerns among advocates for nursing home residents, according to the Associated Press.
The Quinn Administration announced Oct. 16 the selection of six partnerships to launch the state’s transition to expanded coordinated care by 2015.
Although DHS said the selections were based on “ability to offer a holistic approach to delivering coordinated care to special populations,” the Associated Press reported that MADO Management, whose owner is a longtime contributor to Quinn and other Democrat officeholders, was among the partnership entities.
The company is listed as a partner in “Be Well Partners in Health.” The group is to improve health outcomes for adults with severe mental illness and chronic health conditions, including substance abuse, on the north side of Chicago.
However, Wendy Meltzer of Illinois Citizens for Better Care, told the AP that MADO has no track record of helping nursing home residents with severe mental illness live more independently, and at least one of the company’s Chicago homes has received a below average rating on a federal nursing home comparison Web site.
MADO is owned by Peter O’Brien, who also chairs the Illinois Capital Development Board, which oversees state construction projects. He was appointed to the position in 2011 by Quinn. According to the AP, O’Brien is the brother of the late Daniel O’Brien, Jr., a Chicago Democrat who served in the Legislature. According to the Illinois Campaign for Political Reform, from 1993 through 2008, Mado Management gave $387,054 to Illinois Democrat candidates.
The Illinois State Board of Education recently announced that they have finished awarding a total of $39.2 million to schools across the state under the School Maintenance Grant Program. The grants are designed to assist school districts with needed repairs and improvements on existing facilities. The program is a matching grant program with a maximum award of $50,000. In Sen. Sandack’s district, a total of $422,500 was awarded between nine schools, with seven receiving the maximum of $50,000. For more information, visit http://www.isbe.net/sbss/smp_grants.htm.
On Oct. 18, Sen. Sandack participated as a panelist for the Real Estate Investment Association’s monthly meeting along with State Sen. Don Harmon (D-Oak Park) and State Rep. Michael Zalewski (D-Summit). They discussed the state of affairs in Springfield and looked ahead to what will happen in November. Sen. Sandack also participated in the DuPage Business Council’s Town Hall this week, which focused on returning Illinois to a business destination.