1,328 Adults Enrolled In “All Kids Health Insurance” Program Costing Taxpayers $1,192,008.00

Illinois (ECWd) –

Just as exposed in this article, our own Illinois Government reports found on the Auditor General’s website is all the evidence we need to see the level of identified fraud and malfeasance that continues to cost the taxpayers their future in this state.

We asked our readers to simply pick any state agency from the list found at this link and read the auditors’ findings, many of which would constitute a crime.  Then ask yourself, how many people have ever been brought up on charges for malfeasance identified in these official reports?

Do our laws matter anymore?

For today’s coverage, we chose the Performance Audit of the “COVERING ALL KIDS HEALTH INSURANCE PROGRAM,” and sure enough, $1,192,008.00 was spent on Adults rather than Kids.  For those who wish to ignore our coverage, please note that we are not presenting our own findings on the programs, but rather the findings from the Office of the Auditor General, as we are simply the messenger.

Auditors identified 1,328 enrollees that were over the allowable age for enrollment in the ALL KIDS program from July 2018 through March 2020. These enrollees received 11,011 services totaling $1,192,008 after the month of their 19th birthday. Beginning in March 2020, enrollees that were over the allowable age were allowed to maintain coverage because of COVID-19. Auditors also identified duplicate enrollees during FY19 through FY22.

• FY 2019 – 25% annual redeterminations due were not completed
• FY 2020 – (19%) annual redeterminations due were not completed
• Redeterminations were suspended beginning in March 2020 due to COVID-19

Drum Roll Please……..

Supporting documentation for determinations of eligibility has been an issue identified by auditors in each of the previous 10 EXPANDED ALL KIDS audits, going back to FY09.

The Auditor General’s report made recommendations that failed to cite language from the law, but rather used what appears to be auditor-created language. For example, from page [ii] of the report:

• The Department of Healthcare and Family Services and the Department of Human Services should annually redetermine ALL KIDS eligibility as required by the Covering ALL KIDS Health Insurance Act.
• The Department of Healthcare and Family Services should have controls in place to ensure that its ALL KIDS eligibility data is accurate and reliable. This includes ensuring that enrollees over 18 years of age are identified as no longer eligible and ensuring that enrollees are not enrolled in ALL KIDS more than once. 
• The Department of Healthcare and Family Services and the Department of Human Services should: (5 recommendations listed) 
• The Department of Healthcare and Family Services and the Department of Human Services should: (2 recommendations listed) 

What does the law say a bout the items above?

If our laws issue a mandate for these state agencies and those mandates are being ignored, in this case for at least 10 years, why have the law if we are not going to enforce it with punishments for those violating it? I think a safe argument can be made that the failure to comply with this law for 10 years would constitute felony official misconduct under the first prong of the law.

720 ILCS 5/33-3) (from Ch. 38, par. 33-3)
Sec. 33-3. Official misconduct.
(a) A public officer or employee or special government agent commits misconduct when, in his official capacity or capacity as a special government agent, he or she commits any of the following acts:
(1) Intentionally or recklessly fails to perform any mandatory duty as required by law;

When auditors find the same failure in 10 years of audits, most would call that either intentionally or recklessly failing to perform their mandatory duty as required by law.

Does anyone in Government ever get held accountable?

The full report can be downloaded at this link or viewed below.