Capitol Fax.com - Your Illinois News Radar » Behind the numbers
SUBSCRIBE to Capitol Fax      Advertise Here      About     Exclusive Subscriber Content     Updated Posts    Contact Rich Miller
CapitolFax.com
To subscribe to Capitol Fax, click here.
Behind the numbers

Monday, Dec 23, 2013 - Posted by Rich Miller

* Finke reiterates something I told you about a few weeks ago

Now that pension reform is on the books, the anti-public union/public employee folks will have to turn their attention in a new direction for a while.

Thankfully, Medicaid fraud is available to take up the slack.

As part of Medicaid reforms passed a couple of years ago, state agencies were required to review Medicaid rolls to get rid of people no longer eligible for benefits. Face it, if a recipient lives in Wisconsin, Illinois shouldn’t be paying his bills.

The state wasn’t exactly vigilant in dumping ineligible people from the program. Whether this was due to a lack of willpower or lack of manpower is still being argued, although it’s worth noting that the state’s workforce is significantly smaller than it was a decade ago.

Anyway, an arbitrator ruled last summer that the eligibility review work should be done by state employees, not Maximus, the private contractor hired by the state. Last week, the administration announced the results of negotiations to implement the ruling. It includes hiring more than 500 new workers, but also keeping Maximus around in a limited role for a while longer. Immediately, some were predicting doom and gloom because public, rather than private, workers will be doing the work. […]

One number tossed around last week was that Maximus found 40 percent of those receiving benefits were ineligible. At least, that’s how some people characterized it.

Baloney. Maximus reviewed about 497,000 Medicaid cases since the beginning of 2013. Of those, the final review work was completed on about 315,000 cases. And of those, 40 percent were found to be fraudulent and terminated.

So it’s not 40 percent of all Medicaid cases, it’s 40 percent of those checked, which is far less. Also, the ones that were checked first were mostly cases where the state already had suspicions. In other words, easy pickings. Once those are gone, it’s entirely possible the rate of fraud discovered will go down.

It’s more than just entirely possible, it’s almost guaranteed.

* Meanwhile, Crain’s buried a choice nugget deep in a story about business tax credits

Regular EDGE, or Economic Development for a Growing Economy, credits, which reduce a company’s state income taxes, have been awarded to 277 companies, totaling about $800 million, since the program started in 2001. In return, those firms invested nearly $8.5 billion in Illinois and created 49,300 jobs, more than twice the number estimated, according to a spokesman for the Department of Commerce and Economic Opportunity. Another 48,320 jobs were retained, slightly more than expected.

But in recent years, nine companies that pay little or no state income taxes, including Sears Holdings Corp., Motorola Mobility Inc. and Ford Motor Co., have won special legislation allowing them to keep part of the personal state income taxes paid by their employees if they invest and keep or create jobs in Illinois.

“Is that fair to a plumbing company with six people?” says Rep. Jack Franks, D-Marengo, who will co-chair next month’s hearing on business tax incentives. “Can they afford the most-connected lobbyists to go after tax breaks?”

Only Motorola Mobility, now owned by Google Inc., has collected on those credits so far, according to a DCEO spokesman. [emphasis added.]

* From an unemployment benefit story from the Sun-Times

This year has seen a trifecta of challenges for Lynn Richards, 30, of Elgin.

In April, she was laid off from her manufacturing purchasing job of 3½ years.

Her unemployment insurance kicked in, then she became pregnant during her job search.

Now Richards, who is married with a son and hasn’t yet found work, is among 80,000 Illinoisans expected to lose federal Emergency Unemployment Compensation on Saturday.

“I’ve been working since I was 20. I’ve never had this much trouble getting a job in my life. I’ve applied to like 200 places. I’ve gotten less than 10 calls and a couple of interviews,” she said. “Unfortunately now, no employer wants to hire someone [who is] pregnant.”

An estimated 1.3 million Americans who are the long-term unemployed are due to have their benefits cut off just after Christmas because Congress didn’t extend the recession initiative in its compromise budget bill passed by the Senate last week.

Another 1.9 million currently receiving state jobless benefits due to run out the first half of 2014 also will be affected, as they would have qualified for the federal compensation.

* County by county list of those who lost their benefits…

Adams 258
Alexander 33
Bond 92
Boone 328
Brown 13
Bureau 205
Calhoun 27
Carroll 50
Cass 76
Champaign 789
Christian 233
Clark 62
Clay 62
Clinton 158
Coles 218
Cook 38,260
Crawford 92
Cumberland 55
DeKalb 538
DeWitt 89
Douglas 59
Du Page 4,965
Edgar 92
Edwards 13
Effingham 165
Fayette 146
Ford 52
Franklin 349
Fulton 243
Gallatin 39
Greene 68
Grundy 320
Hamilton 43
Hancock 52
Hardin 34
Henderson 10
Henry 226
Iroquois 146
Jackson 233
Jasper 39
Jefferson 227
Jersey 130
Jo Daviess 52
Johnson 66
Kane 3,086
Kankakee 838
Kendall 717
Knox 281
La Salle 933
Lake 3,546
Lawrence 54
Lee 206
Livingston 147
Logan 134
Macon 1,161
Macoupin 291
Madison 1,618
Marion 231
Marshall 71
Mason 95
Massac 48
McDonough 87
McHenry 1,642
McLean 572
Menard 55
Mercer 40
Monroe 88
Montgomery 191
Morgan 187
Moultrie 58
Ogle 326
Peoria 1,546
Perry 131
Piatt 78
Pike 59
Pope 10
Pulaski 34
Putnam 44
Randolph 152
Richland 73
Rock Island 515
Saint Clair 1,667
Saline 220
Sangamon 1,059
Schuyler 38
Scott 26
Shelby 113
Stark 29
Stephenson 337
Tazewell 891
Union 101
Vermilion 533
Wabash 19
Warren 53
Washington 56
Wayne 65
White 62
Whiteside 351
Will 4,474
Williamson 440
Winnebago 2,388
Woodford 193
Total 81,867

       

17 Comments
  1. - Hoping for Rational Thought - Monday, Dec 23, 13 @ 9:46 am:

    If the people removed rom the roles were already in cases that were suspicous or as they say low-hanging fruity, why didn’t anyone DO ANYTHING about it? The Maximus contract forced the issue? Really? So the State knew things were not right and just let it happen? Great defense.


  2. - Rich Miller - Monday, Dec 23, 13 @ 9:47 am:

    ===The Maximus contract forced the issue? Really?===

    No, new state law forced the issue.


  3. - Hoping for Rational Thought - Monday, Dec 23, 13 @ 9:53 am:

    Yes the new law allowed for the Maximus contract but we needed a law to forceState to go after”suspicious” cases and the “low-hanging fruit”? If it was so easy to get these cases why didn’t the State do this before? Why did it take a new law for them to follow existing law?


  4. - Demoralized - Monday, Dec 23, 13 @ 10:11 am:

    @Hoping:

    I’m guessing the state had been reviewing them but they don’t have anywhere the manpower to review as many cases at once as Maximus did.


  5. - A guy... - Monday, Dec 23, 13 @ 10:13 am:

    Anyone else see an effective and meaningful partnership between the State and Maximus here? Even an overall 10-15% recapture of Medicaid abuse would be an astounding number. My own view is it’s closer to 25%, but nowhere close to 40%. It’s a lot of dough, that two partners with motivation to race to the savings could help one another.


  6. - Demoralized - Monday, Dec 23, 13 @ 10:20 am:

    @A guy:

    The unions get touchy when they think somebody is doing work they are supposed to do. You have to do a “mother may I” with the unions any time you want to do a contract. While the unions are right to question work that should be done by employees, they are still failing to grasp the fact that no glut of new employees is forthcoming. They seem to think if they continue to challenge stuff like this the state will hire more people. That ain’t gonna happen. All they do is make it harder on their own employees by piling more work on them or, conversely, cause the work to not get done.


  7. - Pat C - Monday, Dec 23, 13 @ 10:26 am:

    I was under the impression that with the GOOG layoff in fall of 2012, that MOTO Mob went under the number of people employed that was needed.

    So, they may have gotten some, but now they get nothing.


  8. - A guy... - Monday, Dec 23, 13 @ 10:32 am:

    Demoralized…you’re probably correct. sigh. This could work for both of them.


  9. - Excessively Rabid - Monday, Dec 23, 13 @ 11:05 am:

    “…she became pregnant during her job search….”


  10. - wordslinger - Monday, Dec 23, 13 @ 11:07 am:

    Maximus seems to be getting attaboys for picking the low-hanging fruit identified by state employees.

    Why does that make them indispensable in some minds?


  11. - AFSCME Steward - Monday, Dec 23, 13 @ 11:07 am:

    A lot of these cases Maximus identifies as ineligible have to be reinstated. There entire process is very error prone. Additionally, many of the cases cancelled were for people no longer living in Illinois and no longer using Medicaid.

    “One number tossed around last week was that Maximus found 40 percent of those receiving benefits were ineligible. At least, that’s how some people characterized it.”


  12. - AFSCME Steward - Monday, Dec 23, 13 @ 11:12 am:

    Hoping For Rational Thought

    What the Maximus contract brought was more staff & new computer technology. The state neglected both of these for years. In the successful arbitration win, AFSCME demonstrated that the state could have saved millions by keeping the Medicaid determinations in house. The biggest reason for the “low fruit” was staffing shortages. Often the medical redeterminations would not get done because there was noone to do them.

    “Yes the new law allowed for the Maximus contract but we needed a law to forceState to go after”suspicious” cases and the “low-hanging fruit”? If it was so easy to get these cases why didn’t the State do this before? Why did it take a new law for them to follow existing law?”


  13. - AFSCME Steward - Monday, Dec 23, 13 @ 11:23 am:

    Demoralized

    Are you aware that the state is in the process of hiring an additional 520 workers to do the medical redeterminations ? That is in addition to the workers already hired earlier this year.

    “The unions get touchy when they think somebody is doing work they are supposed to do. You have to do a “mother may I” with the unions any time you want to do a contract. While the unions are right to question work that should be done by employees, they are still failing to grasp the fact that no glut of new employees is forthcoming. They seem to think if they continue to challenge stuff like this the state will hire more people. That ain’t gonna happen. All they do is make it harder on their own employees by piling more work on them or, conversely, cause the work to not get done.”


  14. - Anony - Monday, Dec 23, 13 @ 11:30 am:

    ==Maximus reviewed about 497,000 Medicaid cases since the beginning of 2013. Of those, the final review work was completed on about 315,000 cases. And of those, 40 percent were found to be fraudulent and terminated.==

    He’s vague about this. What happened to the unfinished cases? Who’s to say that the rate of fraud isn’t 40% for those also?
    After all, the more ineligible people are removed, the stronger Medicaid will be for those who truly qualify.

    But here’s something about Medicaid and the Affordable Care Act that is getting very little coverage in Illinois. Medicaid is being expanded to those with incomes less than 133% of the poverty level, and the asset test is being dropped. Seems good for those who have a low income or have seen a recent income drop, and have been thrifty enough to save some money for retirement or build some equity in a home. But guess what? Medicaid includes something called “estate recovery.” If you’re 55 or over, and in some cases younger, the value of the health benefits you receive from Medicaid can be extracted from your estate. In other words, Medicaid isn’t exactly health insurance. It’s more like a loan. And the state will seek repayment of the loan.

    Compounding this situation is the fact that if your income is low enough, you don’t have the option of subsidized health insurance, which does not include “estate recovery.” To receive benefits under the ACA, you must enroll in Medicaid. Imagine a situation where people provide an inflated estimate of their income to avoid the government’s “free health coverage.” Mind boggling.

    To alleviate this seeming injustice, some states are looking at modifying their rules for estate recovery. So far Illinois does not seem to be one of those states. But the first step is for Illinoisans to become aware of the issue.

    More on this topic can be found by searching Medicaid estate recovery, but here are three links:

    http://www.pnhp.org/news/2013/december/does-your-estate-belong-to-medicaid
    http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Estate-Recovery.html
    http://www.dailykos.com/story/2013/10/24/1250127/–Medicaid-is-Welfare-It-s-right-to-expect-repayment-With-poll


  15. - DuPage Dave - Monday, Dec 23, 13 @ 12:40 pm:

    The Medicaid ineligibility review is complicated. Too many people with pre-conceived political opinions are not looking into the data. Here’s an update (from September) found on the DHFS web site with about 15 seconds effort:

    “Savings have been less than some legislators hoped but in line with HFS’ forecasts because most of the people cancelled are relatively low users of Medicaid services. Forty percent of the first 105,000 people cancelled had no claims filed on their behalf in the six months before their cancellation. So far, annualized savings on these clients are about $44 million (just in the first 5 months: April — August). This is a per month savings per cancelled client of $58.

    The rate of cancellations will slow, since the queue was deliberately created to put priority cases first: those where data showed a discrepancy and those whose cases had been previously “passively redetermined” (i.e. not reviewed in a long time). The cost savings from these initial early cases likely will not be repeated in subsequent years and should not be relied upon.

    Seventy five percent of the cases cancelled are because the client has failed to respond to the letter asking for additional information. When the electronic data sources do not yield enough information to confirm eligibility, a letter is sent to the client seeking additional information. Clients likely don’t respond to the letter either because they know they are no longer eligible, or because the mail never reaches or is opened by them.

    About 16-19 percent of those cases cancelled this calendar year have already re-enrolled and were found to be eligible — this was expected and is comparable with the re-enrollment rate experienced in the past.”

    In other words, Maximus was given a list of the people most likely to be found ineligible. Many were on the eligible list but had not used any Medicaid services. The average savings per cancelled user was quite small. Most of the cancellations were due not to investigation but due to an individual not responding to a letter. How much work did that take and was it worth the cost of the contract with Maximus?


  16. - Ghost - Monday, Dec 23, 13 @ 3:51 pm:

    lets look sat it like this, back in 2000 or so the State had 60-65k workers.

    The State now has 40-44k workers.

    When yah cut that many employees you stop being able to get work done. What are the easy places to cut? enforcement. Work comp investigators medicaid etc. These employees do not provide mandatory services which move applications and processing, so when you need to trim, they get cut.

    This has always been one of my big concerns with the people who want to donwsize govt. Are we really saving money by elminating jobs? particualry when a lof of the jobs cut are the ones in place to fight fraud. Want a better work comp system? hire more investigators dont cut the work comp budget. and so on


  17. - Anyone Remember? - Monday, Dec 23, 13 @ 4:05 pm:

    Hoping for Rational Thought

    As has been noted by others elsewhere, DHS headcount is down by over one-third since the 2002 ERI - 18.5 thousand at the end of FY 2002 to 11.7 thousand at the end of FY 2012. That is most likely the reason the “re-certifications” weren’t getting done.


Sorry, comments for this post are now closed.


* Reader comments closed for the holidays
* And the winners are…
* SUBSCRIBERS ONLY - Update to previous editions
* Isabel’s afternoon roundup
* Report: Far-right Illinois billionaires may have skirted immigration rules
* Question of the day: Golden Horseshoe Awards (Updated)
* Energy Storage Brings Cheaper Electricity, Greater Reliability
* Open thread
* Isabel’s morning briefing
* SUBSCRIBERS ONLY - Today's edition of Capitol Fax (use all CAPS in password)
* Live coverage
* Selected press releases (Live updates)
* Yesterday's stories

Support CapitolFax.com
Visit our advertisers...

...............

...............

...............

...............

...............

...............

...............


Loading


Main Menu
Home
Illinois
YouTube
Pundit rankings
Obama
Subscriber Content
Durbin
Burris
Blagojevich Trial
Advertising
Updated Posts
Polls

Archives
December 2024
November 2024
October 2024
September 2024
August 2024
July 2024
June 2024
May 2024
April 2024
March 2024
February 2024
January 2024
December 2023
November 2023
October 2023
September 2023
August 2023
July 2023
June 2023
May 2023
April 2023
March 2023
February 2023
January 2023
December 2022
November 2022
October 2022
September 2022
August 2022
July 2022
June 2022
May 2022
April 2022
March 2022
February 2022
January 2022
December 2021
November 2021
October 2021
September 2021
August 2021
July 2021
June 2021
May 2021
April 2021
March 2021
February 2021
January 2021
December 2020
November 2020
October 2020
September 2020
August 2020
July 2020
June 2020
May 2020
April 2020
March 2020
February 2020
January 2020
December 2019
November 2019
October 2019
September 2019
August 2019
July 2019
June 2019
May 2019
April 2019
March 2019
February 2019
January 2019
December 2018
November 2018
October 2018
September 2018
August 2018
July 2018
June 2018
May 2018
April 2018
March 2018
February 2018
January 2018
December 2017
November 2017
October 2017
September 2017
August 2017
July 2017
June 2017
May 2017
April 2017
March 2017
February 2017
January 2017
December 2016
November 2016
October 2016
September 2016
August 2016
July 2016
June 2016
May 2016
April 2016
March 2016
February 2016
January 2016
December 2015
November 2015
October 2015
September 2015
August 2015
July 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004

Blog*Spot Archives
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005

Syndication

RSS Feed 2.0
Comments RSS 2.0




Hosted by MCS SUBSCRIBE to Capitol Fax Advertise Here Mobile Version Contact Rich Miller