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* January 24th Chicago Tribune…
The state agency responsible for overseeing Medicaid in Illinois failed to properly monitor $7.11 billion in payments made to and by managed care organizations, according to a report issued Tuesday by the Illinois auditor general. […]
According to the report, the Department of Healthcare and Family Services could not provide auditors with complete or reliable data that the agency was required to collect under its agreements with the 12 [Managed Care Organizations] it contracted with in 2016. The agency wasn’t able to provide data on paid claims MCOs made to providers; the claims denied by MCOs; administrative costs and coordinated care costs incurred by MCOs; and what percentage of each MCO’s premium income goes to health care and quality improvement as opposed to marketing and other costs, which is information required by federal law.
The report also found that the agency may have made duplicate payments to the MCOs to the tune of $590,237.
* Today…
@RVVoyles and I sat down with @GovRauner today. We asked about a report from auditor gen. on HFS failing to monitor $7 billion in Medicaid bills.
"I heard the reports about that and I'll say this, I think those are fundamentally inaccurate, those are erroneous."
— Tom Lisi (@tommylisi) February 2, 2018
Raw audio is here.
* Transcript…
I think those are fundamentally inaccurate. Those are erroneous. I don’t believe that those, uh, those figures or the, the concerns are valid and we’ll have the truth come out with you guys and others here in the near future… I think there’s misinformation and misunderstandings. I think our teams in these departments are handling our, our managed care program and our Medicaid program very well. There’s been a lot of fraud and abuse and mismanagement in the past, we’re correcting it. And I think the teams are doing a fantastic job. And I think these concerns that somehow there’s not oversight or that there are some missing dollars or whatever, I think, I just don’t think that’s right, that’s erroneous.
* Except, if you click here, you’ll see the Department of Healthcare and Family Services concurred with five out of six of the auditor general’s recommendations. And while DHFS only partially concurred with a sixth recommendation, it said it was addressing the problem a different way.
And this is how the department responded to reporters’ questions…
According to DHFS spokesperson John Hoffman, the department is already implementing changes suggested in the audit. Hoffman says many of these adjustments were made prior to the audit being issued.
“We are confident that HealthChoice Illinois will provide quality, whole-person care for millions of residents while saving taxpayer dollars and operating with vigorous accountability throughout. In addition, the Department contracts with an independent, third party, nationally recognized actuary to assist in this process. We will continually work to improve this program, fiscally and programmatically,” says Hoffman.
posted by Rich Miller
Friday, Feb 2, 18 @ 2:01 pm
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Bruce just called this fake news…..
Comment by Highland Il Friday, Feb 2, 18 @ 2:05 pm
Asked for evidence, Rauner said “I just strongly believe their numbers are wrong.”
Comment by Anonymous Friday, Feb 2, 18 @ 2:05 pm
“Misinformation” is Rauner-speak for “fake news”
Comment by Anonymous Friday, Feb 2, 18 @ 2:11 pm
Sounds like the same attack Blago made when the Auditor’s dinged CMS.
Comment by Norseman Friday, Feb 2, 18 @ 2:15 pm
Yah, I “heard” something about $7B of tax payers funds not being managed properly. But I didn’t ask any questions about it. I was too busy trying to squeeze more than a 300% return on a $5M personal investment.
-Honest Bruce Rauner (fictional of course)
Comment by Henry Francis Friday, Feb 2, 18 @ 2:17 pm
My favorite “Raunerite” fall back word…
… after baloney, corrupt, broken/pineapple…
… fundamental(ly)
Man, Rauner and Raunerites love that.
If Rauner knew “fundamentals” of governing or politics, he’d never have half of the messes he created.
Maybe the Rauner Word Jumble is fixed, I dunno…
Comment by Oswego Willy Friday, Feb 2, 18 @ 2:18 pm
Yes, Bruce, if you deny it often enough it’ll all just go away.
Comment by IllinoisBoi Friday, Feb 2, 18 @ 2:19 pm
Here is this weeks example of what a sham this “Managed Medicaid” is:
6 year old with Leukemia. Rx for an oral anti-fungal. Cost to the pharmacy $600. Reimbursement by the MCO $150.
They expect me to take a loss of $450 and stay in business??
Comment by BIG R. Ph. Friday, Feb 2, 18 @ 2:27 pm
This must be the waste, fraud and abuse that Bruce keeps harping about. Sheesh
Comment by Gruntled University Employee Friday, Feb 2, 18 @ 2:27 pm
Nothing is true anymore unless you hear it from me. Can’t deal.
Comment by Sense of a Goose Friday, Feb 2, 18 @ 2:27 pm
If you’re going to run the government like a business, you’d think that you’d start with bringing out of control vendors to heal. Just impossible to understand why Rauner keeps carrying the MCOs’ water, even though lives are at stake.
Comment by Anonymous Friday, Feb 2, 18 @ 2:32 pm
This guy is clueless. November can’t come soon enough.
Comment by Prairiedog13 Friday, Feb 2, 18 @ 2:34 pm
“Misinformation”=Facts
Comment by 360 Degree TurnAround Friday, Feb 2, 18 @ 2:35 pm
For Immediate Release
Governor Rauner’s Office Presents the First Ever “This I Don’t Believe” Essay Contest. Bonus points will be given to essayists who use the terms “outrageous”, “frustrating”, “erroneous”, “corrupt”, and “Madigan” more than five each times in their 500 word submission. Waste, fraud, and abuse are highly encouraged. Winners will receive a free upgrade of their home and school computer systems by DoIT. Judging will be done by DeLoitte.
(snark, people, snark)
Comment by Anon221 Friday, Feb 2, 18 @ 2:39 pm
He fills his messkit every time he goes to Decatur, I swear.
Comment by Arthur Andersen Friday, Feb 2, 18 @ 2:46 pm
Wow the Governor sinks lower still. Misinformation? HFS agreed with the findings! I guess its a nice change from “It’s Madigan’s fault!” HFS is not doing its job and not collecting the data to monitor MCOs. How does that square with Gov saying they are going after fraud and mismanagement? How do you know there is fraud if you don’t have data? How do you know there are savings if there is no data?
Comment by Hoping for Rational Thought Friday, Feb 2, 18 @ 3:02 pm
Our Governor is more like Blago every day - except Rauner has brought the fiscal damage to greater scope and scale.
Comment by Worse than Blago Friday, Feb 2, 18 @ 3:14 pm
Hoping for Rational Thought, statements like yours give him wriggle room, because you make it sound even worse than it is. You said repeatedly there is no data, instead of saying the data is incomplete and much of what came in in FY 2016 was suspect. I agree HFS was deficient, HFS agrees it was deficient, but I’ve seen articles that say HFS has no idea what MCOs spent, that HFS can’t account for ANY of the $7 billion, which is not what the audit says. Incomplete data is not “no data”. And HFS has started fining MCOs for not sending in good, complete encounter data, here’s the sanctions against FHN: https://www.illinois.gov/hfs/MedicalProviders/cc/Pages/FamilyHealthNetwork.aspx
That being said, I have no idea what the gov is talking about here. They were deficient.
Comment by Anonymous Friday, Feb 2, 18 @ 3:14 pm
Those of us working within this system know well that the findings are accurate, but we’re all too busy trying to survive it to make much noise about it. The details in the media are boring and murky and not sound byte worthy for the general public. Meanwhile, lying Governor Junk has a rapt audience that publishes whatever he says. Guess what’s going to be believed.
Comment by CCP Hostage Friday, Feb 2, 18 @ 4:59 pm
Didn’t Blago make similar comments about Bill Holland after the CMS Audit?
Comment by Smitty Irving Friday, Feb 2, 18 @ 5:15 pm