Auditor General Announces Second Audit, Crespo and Others Urge Attorney General to Investigate HFS Medicaid Spending

SPRINGFIELD, IL – Illinois State Rep. Fred Crespo, D-Hoffman Estates, sent a letter urging Illinois Attorney General Lisa Madigan to investigate the Department of Healthcare and Family Services’ (HFS) Managed Care Organizations (MCOs) program in response to ongoing revelations and the announcement of a second audit by the auditor general. The letter was also signed by state Rep. Emanuel “Chris” Welch, D-Hillside, and state Rep. David McSweeney, R-Barrington Hills.

“I believe the fact that HFS could not come up with complete data on what they spent on administrative costs, or whether the state had overpaid, should raise some eyebrows,” Crespo said. “$7 billion in Medicaid bills that cannot be unaccounted for is not something that should be taken lightly. I applaud the auditor general for looking into this further, taxpayers deserve answers.”

Medicaid managed care organizations, or MCOs, are private insurers that administer benefits for Medicaid. In January, an audit by the auditor general revealed that the DHFS failed to properly monitor $7.11 billion in payments made to and by managed care organizations. Among other things, the report found that the DHFS was unable to provide complete data on what MCOs spent on administrative costs, the number of claims denied, and what percentage of each MCO’s premium income went to health care and quality improvement as opposed to marketing and other costs, which is information required by federal law.

When asked about the audit’s findings, Gov. Bruce Rauner claimed that the findings in the Illinois auditor general’s report were inaccurate, ignoring the fact that his administration had already started implementing some of the report’s recommendations. As a result, Crespo is urging Attorney General Lisa Madigan to conduct an investigation into the MCO program.

“In order to hold government accountable, there must be transparency,” Crespo said. “It is my hope that as the chief law enforcement officer of our state, Attorney General Madigan will look into this further, so the General Assembly can take the necessary steps to ensure tax dollars are being spent appropriately.”