Springfield (ECWd) –
Scandals are nothing new in Illinois, and all too often we find that even when exposed at the highest level of our Government, the problems still don’t get fixed.
Illinois has been trying to modernize its 30-year old Medicaid Management Information System (MMIS) system for years and it appears the efforts are plagued with problems. This upgrade is known as IMPACT, Illinois Medicaid Provider Advanced Cloud Techonology. In light of the security breaches with personal information and the information contained in the letter below, can we actually trust our public officials to fix this problem?
Clear back in early 2013 we began investigating what at the time had all the makings of a movie on public corruption. We first wrote about it in June of 2013. From companies giving out cigars and booze to state workers to secure contracts, while crying they are broke in court cases from other states, the scandal ran deep and was tied to hundreds of millions of dollars.
It was this very State Agency, Health and Family Services, that led to me filing and winning my first ever Pro Se FOIA lawsuit. When they fight giving up records, you know they have something to hide. We knew it was big when we first wrote about it, as did others who followed suit in numerous venues.
Former State Representative Dwight Kay also tried to get answers to no avail, and reading his letter sent in October of 2014, it was clear, major problems existed.
We believe in this case, both now and before, it goes all the way to the Governor’s office. Governor Rauner was made aware of some of these issues in a private email Monday, November 10, 2014, as was Jennifer Hammer, Special Counsel to the Governor in a separate email sent Wednesday, February 11, 2015.
Even though we threw red flags in mid-2013, others did in 2014, and 2015, in an effort to stop the bleeding and malfeasance taking place at HFS, we now find some things just never change in Illinois without outside Federal involvement.
A recent contractor to HFS has submitted her resignation and the 24 bullet-points she outlines, points to some of the very same things we wrote about years ago, thus nothing is getting fixed, either under the Quinn Administration or the Rauner Administration.
Care providers must first be certified in order to be enrolled and able to bill for services under the Code of Federal Regulations. We now have whistleblower claims, backed up with insider source confirmation, those rules are not being complied with and in fact, some personnel have directed those responsible for getting those providers certified to simply “make stuff up” as it relates to their credentials.
“Providers credentialed under the wrong provider types (MD credentialed as a Pediatrician)”
“Project manager Tracy Sims indicated there were at least 700 errors found on applications approved by contractors from January to May 2017. When I asked how the errors were found, I was told it was a manual process by which April Eichen was reviewing. April indicated she found errors including wrong provider types, inaccurate enrollment dates, wrong specialty types, etc. They expected more errors to be discovered.” a. “We were told if the media found out about this it would be a nightmare for Cognizant.”
“Falsification of reports showing the progress of Impact and discussions about the falsification”
“How the death match file is not checked during the enrollment process, because the software is not able to check it as part of the enrollment process, therefore causing deceased providers to be enrolled and that this should be kept secret because if the public knew about it they would be in trouble”
As you can see by reading the resignation letter, HFS clearly has some real problems that were sufficient enough for a true patriot to call them out in a written letter of resignation. She cc’d that communication to the HFS Office of Inspector General in Chicago and Springfield. We assured her we had no confidence in them doing anything as they and other law enforcement were provided much of the same info in 2013 and 2014 and to date nothing has been done, with the exception of spending millions more a month than needed for the programs they committed to through the State of Michigan in an Intergovernmental Agreement. All done to avoid having to bid it out and risk not getting who they wanted.
It should be noted, of the key companies involved in this matter, Cognizant, Cognosante, CNSI. It was reported here that CNSI just happened also to be a contributor listed on Governer Rauners Inauguration donor list to his transition team and inaugural committees. CNSI is listed as an “Up to $10,000” contributor. Other legislators have also received funding from Cognizant employees, which we will get into in future articles. Some of the timing of those contributions will raise some eyebrows, but we doubt any with seriousness enough to fix this problem.
The sad part of this whole mess is the fact the State of Kentucky offered their program to Illinois for free and we turned them down and have now spent hundreds of millions through the largest no-bid contract I believe we have ever seen. This was done through an Intergovernmental Agreement with another state, just so we could use the vendor they wanted who was already under contract with Michigan.
We will update as more documents are obtained but for now, know that we exposed this mess clear back in June of 2013 and no one listened.
Are they listening now?
We suggest the authorities listen up and pay attention; you now have work to do!
You can view all of our history on this matter which is found in numerous articles at the links here and here.
JDPosted at 14:48h, 04 October
Unbelievable – Once again our government is credentialing providers that are deceased or are not suppose to be practicing medicine. I see articles where our tax dollars are going down the drain thanks to our government leaders. See: http://www.foxnews.com/politics/2014/04/18/medicaid-paid-12-million-for-deceased-people-in-illinois-documents-show.html
I have seen nothing showing where Illinois asked for any of the money back or has a unit that goes after those committing fraud. Bruce Rauner has fired less people during his administration than any Governor before him. Take a look at the EOIG stats on that!!
Rauner has failed us because he ran on anti corruption his talk about how corrupt the state is and look what he has done. NOTHING Not even his own staff believe in him all while he took money from contractors!
He could stop this, but he won’t. Thank you for doing what they won’t do. Your small but effective organization has done more for Illinois than Governor Rauner has done. You would think he would pick up the phone and ask how do you dig up so much corruption and put shame to his multiple investigative units.
My Message to the Governor – If you really do care you would answer the call and step up to do something.
Dave nelsonPosted at 21:26h, 19 October
The question is why is the private sector submitting deceased members applications in Impact?
NiteCatPosted at 17:20h, 04 October
Have you passed this info to the Feds who are investigating our Medicaid program??? Also, we’ve heard nothing but crickets on the Medicaid audit since the union tookover, conveniently before the election, last year. Have the 250k beneficiaries , that were found at that time by outside auditors to be ineligible, been removed? So many scandals where our Medicaid program is concerned.