July 19, 2011

Senate Republican Leader Christine Radogno (R-Lemont) is exploring available options after the Obama administration moved to undo key anti-fraud provisions of a bipartisan Medicaid Reform package approved in January.

Obama administration officials are receiving backlash for attempting to block two key provisions included in Illinois’ Medicaid reform law (HB 5420), which passed with strong bi-partisan support. Elected federal and state lawmakers say that by blocking implementation of the reforms the federal government is overreaching its authority and undermining efforts to curb Medicaid fraud.

Radogno and the Senate Republican Caucus have been longtime proponents of bringing accountability and common sense to the Medicaid program and much of the January reform package was based on proposals long advocated by Senate Republicans.

Radogno pointed out that the reforms the Obama administration wants to block are intended to prevent persons ineligible for Medicaid from fraudulently receiving services. The law requires that Medicaid applicants prove they live in Illinois and that they meet income eligibility requirements to qualify for the program. Supporters of the Illinois law point out that the Medicaid reforms in question do not change or curb eligibility—they simply advance greater oversight of the program to ensure Medicaid recipients are eligible. State lawmakers from both parties advanced the reforms to target inefficiencies and fraud within the system.

The Obama administration's Centers for Medicare and Medicaid Services claim the anti-fraud provisions of the new law do not comply with the federal health care reform law, because federal law restricts states from changing eligibility in the Medicaid program. Federal officials contend that Illinois’ reforms violate the federal law by limiting Medicaid eligibility, even though the Act does not affect persons legitimately eligible for Medicaid.

Although the eligibility verifications are the only portion of the law challenged so far by the federal government, in a letter to the State Department of Healthcare and Family Services, Obama administration official Cindy Mann left open the possibility that they may attempt to undo other provisions of the Medicaid reform law, saying that since there is an Oct. 1 date for those provisions to go into effect, "we will respond to those issues separately."