HR1295 95TH GENERAL ASSEMBLY

HR1295 LRB095 21398 DRJ 50807 r

HOUSE RESOLUTION

WHEREAS, The Illinois Public Aid Code (305 ILCS 5/) sets out criteria, standards and procedures governing the Medical Assistance (Medicaid) Program that pays for the medical care for elderly and disabled persons whose needs may best be met by qualified long term care providers; and

WHEREAS, Eligibility for the Medical Assistance Program includes a determination of the financial resources available to the applicants to cover the cost of care, and a finding by the Department of Healthcare and Family Services together with the Department of Human Services regarding applicants' responsibility for payment for care; and

WHEREAS, The Medical Assistance Program pays for the care to the extent that an applicant's or recipient's financial resources are not sufficient to cover this cost; and

WHEREAS, There have been instances in which the Department of Healthcare and Family Services together with the Department of Human Services has committed errors in the eligibility determination process, including but limited to incorrect processing and evaluation of the applications and the financial information provided on behalf of the applicant or recipient, incorrect assessment of the applicant's or recipient's payment or spenddown responsibility, and failure to correct these errors on a timely basis; and

WHEREAS, Errors in the determinations of eligibility and the assessment of the financial resources of applicants or recipients who require long term care can incorrectly result in the qualification and disqualification of persons, or in excessive personal liability of the applicant or recipient; and

WHEREAS, It is critical that the eligibility determination process function effectively to ensure the proper expenditure of public funds, as well as coverage for those persons who are in need of and entitled to assistance; therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE NINETY-FIFTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that the Auditor General of the State of Illinois is directed to audit the Medical Assistance Program jointly administered by the Illinois Departments of Healthcare and Family Services and Human Services with respect to the accuracy and impact of eligibility determination standards and procedures regarding persons applying for or receiving assistance for long term care, with particular emphasis on the nature and scope of errors in the assessment of the financial resources and financial liability of the applicants and recipients; and be it further

RESOLVED, That the Department of Healthcare and Family Services, the Department of Human Services, and any other State agency, entity or person that may have information relevant to this audit cooperate fully and promptly with the Auditor General's Office in its conduct; and be it further

RESOLVED, That the Auditor General report the conclusions of this audit as soon as possible and make public the findings and recommendations upon completion in accordance with the provisions of Section 3-14 of the Illinois State Auditing Act; and be it further

RESOLVED, That copies of this resolution be delivered to the Auditor General, the Director of Healthcare and Family Services, and the Secretary of Human Services.