Full Text of HR1104 100th General Assembly
HR1104 100TH GENERAL ASSEMBLY |
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| 1 | | HOUSE RESOLUTION
| 2 | | WHEREAS, Over 3 million low-income children, pregnant | 3 | | women, adults, seniors, and people with disabilities are | 4 | | currently enrolled in the Illinois Medical Assistance Program | 5 | | (Medicaid) administered by the Department of Healthcare and | 6 | | Family Services; and
| 7 | | WHEREAS, In Fiscal Year 2016, State spending on Medicaid | 8 | | services reached over $19 billion; and
| 9 | | WHEREAS, It is estimated that 10% of all Medicaid claims | 10 | | made to the Department of Healthcare and Family Services are | 11 | | fraudulent accounting for an annual loss of $2 billion in State | 12 | | moneys; and
| 13 | | WHEREAS, Most Medicaid fraud is committed by doctors, | 14 | | nurses, pharmacists, and other medical providers who submit | 15 | | false claims or employ fraudulent schemes to obtain Medicaid | 16 | | funds, including billing for services not rendered, billing | 17 | | duplicate times for one service, falsifying a diagnosis, | 18 | | billing for a more costly service than performed, accepting | 19 | | kickbacks for patient referrals, billing for a covered service | 20 | | when a noncovered service was provided, ordering excessive or | 21 | | inappropriate tests, prescribing medicines that are not | 22 | | medically necessary or for use by people other than the | 23 | | patient, or billing related tests or procedures as individual |
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| 1 | | visits to drive up the total cost; and
| 2 | | WHEREAS, Medicaid fraud and abuse divert State and federal | 3 | | funding from legitimate health care services, increase State | 4 | | health care costs, and expose persons eligible for Medicaid | 5 | | services to unnecessary and potentially harmful medical | 6 | | procedures; and
| 7 | | WHEREAS, Illinois has a vested interest in preventing | 8 | | Medicaid provider fraud in order to safeguard the integrity of | 9 | | the Illinois Medical Assistance Program, contain health care | 10 | | costs, and ensure that persons eligible for medical assistance | 11 | | have access to high quality health care; therefore, be it
| 12 | | RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE | 13 | | HUNDREDTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we | 14 | | urge the Department of Healthcare and Family Services to take a | 15 | | more aggressive approach to preventing and detecting provider | 16 | | fraud and abuse under the Illinois Medical Assistance Program | 17 | | by identifying and eliminating program deficiencies that | 18 | | enable Medicaid providers to overbill and falsify Medicaid | 19 | | claims, including billing for services not rendered, charging | 20 | | more than the fair-market value for covered services, and | 21 | | admitting Medicaid beneficiaries for inappropriate hospital | 22 | | stays; and be it further
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| 1 | | RESOLVED, That a suitable copy of this resolution be
| 2 | | delivered to the Director of the Department of Healthcare and | 3 | | Family Services.
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