In our opinion, except for the material noncompliance with the specified requirements described in the accompanying Schedule of Findings as items 2025-001 and 2025-002, the Department complied with the specified requirements during the two years ended June 30, 2025, in all mat…
The audit identified significant delays, data inaccuracies, and reporting deficiencies in Illinois' Medicaid long-term care eligibility process. While some system enhancements have been implemented, issues remain with timeliness, data integrity, and reporting practices. The ag…
The audit revealed significant discrepancies between estimated and actual enrollment and costs, issues with data accuracy and eligibility verification, and the need for improved controls to prevent ineligible or duplicate enrollments. These findings highlight the importance of…
HFS failed to maintain complete and accurate data to monitor payments to and from MCOs, leading to potential overpayments, duplicate payments, and lack of oversight on costs and claims processing.