$7 Billion in Illinois Medicaid Funds Unaccounted For

Audit finds unaccounted for funds, some paid twice by Medicaid

EYEWITNESS NEWS CAPITOL BUREAU - A state audit is casting more doubt over Governor Bruce Rauner's Medicaid Managed Care Program reboot.

The report just released, reveals the Department of Health and Family Services can't account for more than $7 billion spent between the state and insurers. Numbers are based on fiscal year 2016. 

According to the Auditor General, DHFS couldn't provide a list of important details regarding the state's Medicaid program. Among the information missing was the number of claims paid to Medicaid providers, the number of claims denied and administrative costs.

The report also shows the department paid 302 people twice, which cost the state thousands.

Last year, lawmakers requested this audit while Rauner pursued expansion plans. 

The governor's new Medicaid program, HealthChoice Illinois went into effect January 1.  It will cost tax payers more than $60 billion over the course of four years. When proposing the idea, Rauner repeatedly claimed the program would save taxpayers up to $300 million each year. Now critics, including Comptroller Susana Mendoza, are asking, how?

She released this statement: “The Auditor General’s findings make it clear the Rauner Administration is unable or unwilling to answer fundamental questions about its gross mishandling of Medicaid Managed Care Program.”

She and others are calling the governor to be more transparent with calculations.

According to DHFS spokesperson John Hoffman, the department is already implementing changes suggested in the audit. Hoffman says many of these adjustments were made prior to the audit being issued.

“We are confident that HealthChoice Illinois will provide quality, whole-person care for millions of residents while saving taxpayer dollars and operating with vigorous accountability throughout. In addition, the Department contracts with an independent, third party, nationally recognized actuary to assist in this process. We will continually work to improve this program, fiscally and programmatically,” says Hoffman.

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