Illinois pays millions in medical costs for dead people

News

SPRINGFIELD, Ill. (WCIA) — Illinois paid over 4 million dollars for people who died, but their records were never updated in the Department of Healthcare and Family Services’ system.

The U.S. Department of Health and Human Services Office of the Inspector General conducted the audit. The office reviewed DHFS from October 1st, 2015 to September 30th, 2018.

Under the state’s old fee-for-service program, the money would have stayed in-house, but the state now pays Managed Care Organizations for people at a monthly rate. That means It is in the pockets of the private managed care organizations, and now the state has to work to get it back. 

The problem stemmed from poor record keeping. The DHFS record system was not updated, and people who passed away were still listed as alive. 

Sangamon County Coroner Cinda Edwards was surprised to hear the state was letting people slip through the cracks. 

“In every situation, communication is key,” Edwards said. “I think there needs to be a communication system in place where that is reported to the other department.”

Her office, along with coroners across the state, enters information into a database when somebody dies.

That database is used to shut down social security benefits, but not medical care costs.

“It sure is a lot of money being paid out,” Edwards said. “Surely we get it back, but that is not without employee time, or resources being used, when it shouldn’t have gone out in the first place.”

The state’s contracts with managed care organizations provides a way to recover the money.

DHFS spokesman John Hoffman says that process has already started.

“With an experienced new management team, we are aggressively resolving problems such as those raised by this audit, which took place more than a year before this administration began,” John Hoffman, spokesperson for DHFS said. “As the audit states, the department agrees with the recommended solutions and is implementing a range of initiatives that have begun to recoup this money and prevent similar future errors.”

These kinds of costly mistakes happen more often than you might think.

A review conducted by the State Auditor General in 2013 found DHFS made the same mistake, but that time it cost more than 12 million dollars. Another audit in 2014 found the state paid $3.7 million in medical costs for 1,111 dead people.

It also recommended that the state review the time period both before and after the audited period for similar mistakes.

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