Rep. Patricia R. Bellock
Filed: 3/22/2010
 
 

 




 

 		












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AMENDMENT TO HOUSE BILL 5242




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    AMENDMENT NO. ______. Amend House Bill 5242 by replacing 
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everything after the enacting clause with the following:

 
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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 
 


 






09600HB5242ham001
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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 
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Office of the Inspector General or any other authorized agency 
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employee from performing activities to identify and prevent 
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improper payments. 
 

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    Section 99. Effective date. This Act takes effect upon 
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becoming law.".