Illinois General Assembly - Full Text of HB5242
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Full Text of HB5242  96th General Assembly


Rep. Patricia R. Bellock

Filed: 3/22/2010





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2     AMENDMENT NO. ______. Amend House Bill 5242 by replacing
3 everything after the enacting clause with the following:
4     "Section 5. The Illinois Public Aid Code is amended by
5 adding Section 12-4.40 as follows:
6     (305 ILCS 5/12-4.40 new)
7     Sec. 12-4.40. Payment Recapture Audits. The Department of
8 Healthcare and Family Services is authorized to contract with
9 third-party entities to conduct Payment Recapture Audits to
10 detect and recapture payments made in error or as a result of
11 fraud or abuse. Payment Recapture Audits under this Section may
12 be performed in conjunction with similar audits performed under
13 federal authorization.
14     A Payment Recapture Audit shall include the process of
15 identifying improper payments paid to providers or other
16 entities whereby accounting specialists and fraud examination



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1 specialists examine payment records and uncover such problems
2 as duplicate payments, payments for services not rendered,
3 overpayments, payments for unauthorized services, and
4 fictitious vendors. This audit may include the use of
5 professional and specialized auditors on a contingency basis,
6 with compensation tied to the identification of misspent funds.
7     The use of Payment Recapture Audits does not preclude the
8 Office of the Inspector General or any other authorized agency
9 employee from performing activities to identify and prevent
10 improper payments.
11     Section 99. Effective date. This Act takes effect upon
12 becoming law.".