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HB5242 Engrossed |
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LRB096 18832 KTG 34218 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by |
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| adding Section 12-4.40 as follows: |
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| (305 ILCS 5/12-4.40 new) |
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| Sec. 12-4.40. Payment Recapture Audits. The Department of |
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| Healthcare and Family Services is authorized to contract with |
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| third-party entities to conduct Payment Recapture Audits to |
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| detect and recapture payments made in error or as a result of |
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| fraud or abuse. Payment Recapture Audits under this Section may |
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| be performed in conjunction with similar audits performed under |
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| federal authorization. |
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| A Payment Recapture Audit shall include the process of |
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| identifying improper payments paid to providers or other |
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| entities whereby accounting specialists and fraud examination |
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| specialists examine payment records and uncover such problems |
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| as duplicate payments, payments for services not rendered, |
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| overpayments, payments for unauthorized services, and |
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| fictitious vendors. This audit may include the use of |
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| professional and specialized auditors on a contingency basis, |
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| with compensation tied to the identification of misspent funds. |
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| The use of Payment Recapture Audits does not preclude the |