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Governor Rauner Announces Recommendations from Health Care Fraud Elimination Task Force Report

Press Release - Wednesday, October 19, 2016

Recommendations improve delivery of care and save taxpayer dollars

CHICAGO - Governor Bruce Rauner today announced the initial findings of the Health Care Fraud Elimination Task Force. The report is in response to an Executive Order creating the Health Care Fraud Elimination Task Force signed by Governor Rauner in April. The Task Force was charged with looking strategically and comprehensively into fraud, waste and abuse in taxpayer-funded health care systems to ensure our most vulnerable populations receive the care they need.

"Every dollar that is improperly spent in our health care programs is a dollar that is not reaching our most vulnerable residents," Governor Rauner said. "We must be accountable to those we serve and ensure that our health care programs are run compassionately, effectively and free of improper spending."

The Task Force has already taken simple, but effective steps to improve how the state delivers health care to our most vulnerable, while driving better value for taxpayers. One example is in the state group health plan. Central Management Services audited all dependents the state was paying for and found about 6,000 people were receiving benefits from the state that did not qualify for those benefits. Taking action to remove those individuals from their plans saved the State approximately $22 million in FY16 and is estimated to save over $32 million in FY17.

The Governor was joined by Executive Inspector General Maggie Hickey, Department of Healthcare and Family Services Director Felicia Norwood, Illinois CIO and Secretary Designate of the Department of Innovation & Technology Hardik Bhatt, Illinois State Police Captain Brian Ley and Healthcare and Family Services Inspector General Brad Hart.

"The value of reducing fraud, waste, and abuse is immense, and in these economic times, would allow the State to utilize funds currently being misspent to provide better programs and services," Executive Inspector General Maggie Hickey said.

In FY15, the states and federal government spent approximately $548 billion dollars on Medicaid and Illinois' portion was about $18 billion. In that same year, the United States Department of Health and Human Services estimates that Medicaid also made about $29 billion in improper payments.

"The Department of Healthcare and Family Services is energized by the prospect of strengthening its approaches to fight fraud and abuse, ensuring that public funds go to the people who need them," Illinois Healthcare and Family Services Director Felicia Norwood said. "We cooperated very closely with the task force to provide information and help develop these strong recommendations. We need effective and leading-edge ways to confront those who would take advantage of our programs, especially with new healthcare delivery models of today."

"Harnessing the enormous power of data through real-time and predictive analytics will allow Illinois agencies to save millions of taxpayer dollars," stated Hardik Bhatt, Illinois CIO and Secretary Designate of the Department of Innovation & Technology.

The Rauner Administration has made a concerted effort to drive savings for taxpayers in these health care systems including $220.2 million in savings, recoupment and avoidance for the state's Medicaid program in FY 2016. Through improved fraud, waste, and abuse identification and prevention efforts the task force recommended, the state will realize approximately $50 million in additional savings.

"Whether we're discussing ways to strengthen our healthcare programs or investigating a complex criminal fraud investigation, the task force approach is an avenue to share resources and discuss the most efficient and effective methodology," Illinois State Police Captain Brian Ley said. "Under the direction of the Governor's Office and the Executive Inspector General, the State Agencies involved on the Task Force are working collaboratively to implement strategies to reduce fraud, waste, and abuse."

"While we have made great strides to become a national leader in the realm of Medicaid program integrity, there is still much more that we can do," Healthcare and Family Services Inspector General Brad Hart said. "The Task Force report highlights some of those areas where all of the entities involved can work better together to achieve the greatest return for the taxpayers."

The full Task Force Report can be viewed here.

Video of the event will be posted here.

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