Bill Text: IL SB3890 | 2021-2022 | 102nd General Assembly | Introduced

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Bill Title: Amends the Illinois Public Aid Code. Requires the Auditor General to conduct a performance audit on the Department of Healthcare and Family Services to review and assess the Department's protocols for detecting and preventing Medicaid fraud and abuse under the State's medical assistance program. Provides that the audit shall cover the Department's administration of the medical assistance program during State fiscal years 2020 through 2022. Requires the Auditor General to, at a minimum, review, evaluate, and report to the General Assembly on the following: (1) the total amount in payments the Department made during the reporting period on behalf of medical assistance beneficiaries; (2) the total amount of those payments that were made in error or as a result of fraud or abuse during the reporting period, including duplicate payments, payments for services not rendered, payments for unauthorized services, payments to fictitious vendors, payments made on behalf of deceased beneficiaries, and payments made on behalf of individuals for any period during which they were ineligible to receive medical assistance; (3) the total amount of payments made in error that were recovered by the Department; (4) emerging trends of fraud, waste, and abuse under the medical assistance program and the Department's actions to identify and address these emerging trends; (5) the frequency and success of eligibility checks conducted during the reporting period to prevent the improper use of State and federal Medicaid funds; and (6) the Department's compliance with applicable State and federal requirements concerning fraud detection and prevention. Requires the Auditor General to commence the audit as soon as possible and report his or her findings to the General Assembly no later than 2 years after the effective date of the amendatory Act. Requires the Auditor General's report to include any issues or deficiencies and recommendations. Effective immediately.

Spectrum: Partisan Bill (Republican 3-0)

Status: (Introduced - Dead) 2022-01-21 - Referred to Assignments [SB3890 Detail]

Download: Illinois-2021-SB3890-Introduced.html

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102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 SB3890 Introduced 1/21/2022, by Sen. Brian W. Stewart - Chapin Rose - Dale Fowler SYNOPSIS AS INTRODUCED:
305 ILCS 5/12-14.2 new
Amends the Illinois Public Aid Code. Requires the Auditor General to conduct a performance audit on the Department of Healthcare and Family Services to review and assess the Department's protocols for detecting and preventing Medicaid fraud and abuse under the State's medical assistance program. Provides that the audit shall cover the Department's administration of the medical assistance program during State fiscal years 2020 through 2022. Requires the Auditor General to, at a minimum, review, evaluate, and report to the General Assembly on the following: (1) the total amount in payments the Department made during the reporting period on behalf of medical assistance beneficiaries; (2) the total amount of payments identified in paragraph (1) that were made in error or as a result of fraud or abuse during the reporting period, including duplicate payments, payments for services not rendered, payments for unauthorized services, payments to fictitious vendors, payments made on behalf of deceased beneficiaries, and payments made on behalf of individuals for any period during which they were ineligible to receive medical assistance; (3) the total amount of payments identified in paragraph (2) that were recovered by the Department; (4) emerging trends of fraud, waste, and abuse under the medical assistance program and the Department's actions to identify and address these emerging trends; (5) the frequency and success of eligibility checks conducted during the reporting period to prevent the improper use of State and federal Medicaid funds; and (6) the Department's compliance with applicable State and federal requirements concerning fraud detection and prevention. Requires the Auditor General to commence the audit as soon as possible and report his or her findings to the General Assembly no later than 2 years after the effective date of the amendatory Act. Requires the Auditor General's report to include any issues or deficiencies and recommendations. Effective immediately.
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A BILL FOR
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AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
adding Section 12-14.2 as follows:
(305 ILCS 5/12-14.2 new)
Sec. 12-14.2. Auditor General; medical assistance fraud.
The Auditor General shall conduct a performance audit on the
Department of Healthcare and Family Services to review and
assess the Department's protocols for detecting and preventing
Medicaid fraud and abuse under the State's medical assistance
program. The audit shall cover the Department's administration
of the medical assistance program during State fiscal years
2020 through 2022. At a minimum, the Auditor General shall
review, evaluate, and report to the General Assembly on the
following:
(1) The total amount of payments the Department made
during the reporting period on behalf of medical
assistance beneficiaries.
(2) The total amount of payments identified in
paragraph (1) that were made in error or as a result of
fraud or abuse during the reporting period. The reported
amount under this paragraph shall, at a minimum, include

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and identify duplicate payments, payments for services not
rendered, payments for unauthorized services, payments to
fictitious vendors, payments made on behalf of deceased
beneficiaries, and payments made on behalf of individuals
for any period during which they were ineligible to
receive medical assistance.
(3) The total amount of payments identified in
paragraph (2) that were recovered by the Department
through recoupment, setoff, crediting of future billings,
or direct repayment.
(4) Emerging trends of fraud, waste, and abuse under
the medical assistance program and the Department's
actions to identify and address these emerging trends.
(5) The frequency and success of eligibility checks
conducted during the reporting period to prevent the
improper use of State and federal Medicaid funds.
(6) The Department's compliance with applicable State
and federal requirements concerning fraud detection and
prevention.
The Department of Healthcare and Family Services and, if
applicable, the Department of Human Services shall cooperate
with the Auditor General in the conduct of this audit.
The Auditor General shall commence this audit as soon as
possible and report his or her findings to the General
Assembly no later than 2 years after the effective date of this
amendatory Act of the 102nd General Assembly. The Auditor

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General's report shall include any issues or deficiencies and
recommendations. The audit required by this Section shall be
in accordance with and subject to the Illinois State Auditing
Act.
Section 99. Effective date. This Act takes effect upon
becoming law.