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June 25, 2010

Governor Quinn Signs Medicaid Reform Legislation
New Laws will Fight Fraud, Improve Transparency and Efficiency in State’s Medicaid Program

CHICAGO – June 25, 2010. Governor Pat Quinn today signed three bills into law that will fight fraud and increase the transparency and efficiency of Illinois’ Medicaid program.

“Providing health care to those who need it is one of my top priorities,” said Governor Quinn. “These new laws will help increase transparency and accountability in the state’s Medicaid program and help us to root out fraud and abuse to ensure that taxpayer dollars are used wisely.”

House Bill 5241 creates the Medicaid Transparency Program. The legislation, sponsored by Sen. Kirk Dillard (R-Hinsdale) and Rep. Patrica Bellock (R-Hinsdale), allows the state to post Medicaid claims data online. The new law will provide important access to information on how taxpayer dollars are used for the state’s Medicaid program while protecting confidentiality of personal medical data.

House Bill 5242 will help reduce fraud and abuse in the Medicaid program by allowing the state to contract with third parties to conduct audits to recover funds that are paid out in error or through fraud and abuse. These efforts would build on the previously announced directive from President Obama to expand and intensify the use of payment recapture audits. The bill was also sponsored by Sen. Dillard and Rep. Bellock.

House Bill 5054 will streamline services and reduce costs by allowing the Illinois Department of Healthcare and Family Services (HFS) to issue Medicaid cards on a permanent basis instead of monthly. Under current law, Medicaid recipients receive an eligibility card every month. The new law allows HFS to issue a permanent card and requires Medicaid providers to verify eligibility using an electronic verification system prior to rendering services. The bill was sponsored by Sen. Jacqueline Collins (D- Chicago) and Rep. Karen May (D-Highwood).

“In these tough economic times, we are all looking for ways to streamline government and make it more efficient to save precious dollars that can be better spent serving the citizens of Illinois,” said Rep. May. “I would like to thank Governor Quinn and his agencies for working on this creative idea.”

All three bills passed the Illinois General Assembly unanimously. House Bills 5241 and 5242 take effect immediately, and House Bill 5054 takes effect July 1, 2011.

“As Illinois moves toward implementing national healthcare reform, it is vitally important that we take advantage of fast-paced improvements in healthcare information technology to both improve health outcomes and to increase transparency and accountability,” said HFS Director Julie Hamos. “We will make every effort to make data accessible and ensure that only those who are legally eligible for care receive it.”

HFS is also implementing an innovative managed care pilot program that was announced by Governor Quinn last summer. The program will provide adults with disabilities and older adults in the Medicaid program with the full spectrum of covered services through an integrated care delivery system. The goal is to achieve better health outcomes by improving coordination among providers. Better coordination will also control costs by reducing unnecessary hospitalization, repeat testing and emergency room use. The agency is currently evaluating five proposals that will affect approximately 40,000 individuals in suburban Cook, DuPage, Kane, Kankakee, Lake and Will Counties.


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