By Bruce Japsen | A
private insurance company that manages health benefits for the Illinois
Medicaid health insurance program for the poor will repay state coffers
about $1 million after the plan overbilled the state for a three-year
period.
Wellcare Health Plans Inc., the largest Medicaid HMO operating in
Illinois, said a “calculation error resulted in a minimum overstatement
of capitation expense,” the Tampa, Fla.-based health insurance company
said. The overbilling amounted to about 0.2 percent of the premium
amount for the period July 2006 through June 2009, Wellcare said.
Wellcare’s Harmony health plan subsidiary provides health benefits to 146,000 Illinois residents in the Medicaid program. The Illinois Department of Healthcare and Family Services, which runs the state’s Medicaid program for the poor, said Wellcare “notified the state of the finding by their auditors, and the state will receive a credit for the overpayment,” department spokesman Mike Claffey said.
In Illinois, the Medicaid managed-care program has fewer than 200,000 of the state’s 1.9 million Medicaid recipients largely because it is voluntary. Wellcare is the largest private insurer participating in the Medicaid managed care program.
But health officials in Gov. Pat Quinn’s administration are considering requirements that would put more state Medicaid recipients into HMOs. Some state officials see requiring Medicaid patients to enroll in HMOs would save money, particularly at a time the state is facing a $13 billion budget hole.
HMOs are the most restrictive form of health insurance in that they limit their subscribers choices to doctors and hospitals. HMOs say they help the state control costs because Medicaid patients are assigned a primary care physicians and a network of services – an arrangement meant to more closely follow their care and keep them out of expensive hospital settings.
Meanwhile, the state awaits bids from HMOs that may be interested in a pilot program that would place some elderly, blind and disabled Medicaid patients into HMOs. State officials have issued a request for proposals by managed-care plans to provide medical care services to 40,000 seniors and adults with disabilities in suburban Cook, DuPage, Kankakee and Will counties.
The Medicaid patients have to enroll in one of two health plans. Proposals are due May 14 in hopes of launching the program in the fourth quarter of this year, Claffey said.
One more example of government being inept! When I get a bill I review it and make sure it is accurate the government apparently doesn’t have the sense to do that or maybe the people they employ are nitwits who are more interested in coffee breaks than doing a thorough job-perhaps union employees?
Yet with all the constant problems with the government doing anything correctly Obama and his minions want us to believe they can control health care and see that we are not overcharged. Now these same fools are telling us how they will watch over the financial system-the same dopes like Chris Dodd, Barney Frank, Maxine Waters who profited from Fannie Mae and Freddie Mac at the taxpayers expense and should have been warning us of the coming catastrophe these three were saying two weeks before the crash how safe Fanny and Freddie were as investments.
Of course the lousy Chicago Tribune has ignored the story the same as they are ignoring the Arizona illegal situation where all legal immigrants for 70 years have had to carry a green card and identify themselves as legal immigrants to obey the law Now Gutierrez and his illegal friends bring up the “identification which is the law for 70 years, now they say it is a nazi trick. These people are dishonest and The Tribune doesn’t hold them accountable or doesn’t know the current law. We want legal immigration only why is that so hard to understand? Mexico rapes, murders, extorts and beats any illegals caught in Mexico and has the Tribune said one word about this fiasco no and neither has Gutierrez.