Synopsis As Introduced Amends the Illinois Public Aid Code. Provides that no later then January 1, 2011, the Inspector General of the Department of Healthcare and Family Services shall contract with an independent certified public accountant to perform a forensic audit of the medical assistance program under Article V of the Code as well as additional programs which receive funds through common budgetary lines appropriated to the Department of Healthcare and Family Services for comprehensive medical assistance operated under the Children's Health Insurance Program Act and the Covering ALL KIDS Health Insurance Act. Provides that the forensic audit shall include, but not be limited to, a review of the application and enrollment of individuals for services and reimbursements to providers for medical assistance, and that the audit shall focus on any fraud or inefficiencies which may be eliminated to contain costs and improve the delivery of care to eligible individuals. Requires the Director of the Department of Healthcare and Family Services to report the findings of the audit to the General Assembly along with recommendations to address any adverse findings contained in the audit. Effective immediately.
House Floor Amendment No. 1 Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services is authorized to contract with third-party entities to conduct Payment Recapture Audits to detect and recapture payments made in error or as a result of fraud or abuse. Further provides that a Payment Recapture Audit shall include the process of identifying improper payments paid to providers or other entities whereby accounting specialists and fraud examination specialists examine payment records and uncover such problems as duplicate payments, payments for services not rendered, overpayments, payments for unauthorized services, and fictitious vendors. Effective immediately.