97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5905
 
Introduced 2/16/2012, by Rep. Patricia R. Bellock
 
SYNOPSIS AS INTRODUCED:
 

 
305 ILCS 5/12-4.40

     Amends the Administration Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall contract (rather than is authorized to contract) with third-party entities to conduct Payment Recapture Audits to detect and recapture payments made in error or as a result of fraud or abuse. Effective immediately.
  


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FISCAL NOTE ACT MAY APPLY
 
 
A BILL FOR
 

  
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1    AN ACT concerning public aid.
  
 
2    Be it enacted by the People of the State of Illinois,
 
3represented in the General Assembly:
  
 
 
4    Section 5. The Illinois Public Aid Code is amended  by 
5changing Section 12-4.40 as follows:
 
6    (305 ILCS 5/12-4.40)
7    Sec. 12-4.40. Payment Recapture Audits. The Department of 
8Healthcare and Family Services shall is authorized to contract 
9with third-party entities to conduct Payment Recapture Audits 
10to detect and recapture payments made in error or as a result 
11of fraud or abuse. Payment Recapture Audits under this Section 
12may be performed in conjunction with similar audits performed 
13under federal authorization.
14    A Payment Recapture Audit shall include the process of 
15identifying improper payments paid to providers or other 
16entities whereby accounting specialists and fraud examination 
17specialists examine payment records and uncover such problems 
18as duplicate payments, payments for services not rendered, 
19overpayments, payments for unauthorized services, and 
20fictitious vendors.  This audit may include the use of 
21professional and specialized auditors on a contingency basis, 
22with compensation tied to the identification of misspent funds. 
23    The use of Payment Recapture Audits does not preclude the 
 
 
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1Office of the Inspector General or any other authorized agency 
2employee from performing activities to identify and prevent 
3improper payments. 

4(Source: P.A. 96-942, eff. 6-25-10; 97-333, eff. 8-12-11.)
 
 
5    Section 99. Effective date. This Act takes effect upon 
6becoming law.