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Doug Finke

Private firm takes it on chin

Public staffers will take over eligibility work

Public staffers will take over eligibility work

Now that pension reform is on the books, the anti-public union/public employee folks will have to turn their attention in a new direction for a while.

Thankfully, Medicaid fraud is available to take up the slack.

As part of Medicaid reforms passed a couple of years ago, state agencies were required to review Medicaid rolls to get rid of people no longer eligible for benefits. Face it, if a recipient lives in Wisconsin, Illinois shouldn’t be paying his bills.

The state wasn’t exactly vigilant in dumping ineligible people from the program. Whether this was because of a lack of willpower or lack of manpower is still being argued, although it’s worth noting that the state’s workforce is significantly smaller than it was a decade ago.

Anyway, an arbitrator ruled last summer that the eligibility review work should be done by state employees, not Maximus, the private contractor hired by the state.

Last week, the administration announced the results of negotiations to implement the ruling. It includes hiring more than 500 new workers, but also keeping Maximus around in a limited role for a while longer.

Immediately, some were predicting doom and gloom because public, rather than private, workers will be doing the work.

It will be interesting to see whether the public workers will uncover enough fraud to satisfy the naysayers, or whether they will ever be able to produce enough to satisfy those who think the private sector can do it better.

As Gov. Pat Quinn said, in explaining why the state didn’t further pursue a challenge to the arbitrator’s decision: “I don’t want to spend the rest of my life in court. There is a curse – may your life be filled with lawyers. I don’t intend to have that happen to us or the state of Illinois.”

40 percent?


One number tossed around last week was that Maximus found 40 percent of those receiving benefits were ineligible. At least, that’s how some people characterized it.

Baloney. Maximus reviewed about 497,000 Medicaid cases since the beginning of 2013. Of those, the final review work was completed on about 315,000 cases. And of those, 40 percent were found to be fraudulent and terminated.

So it’s not 40 percent of all Medicaid cases, it’s 40 percent of those checked, which is far less. Also, the ones that were checked first were mostly cases where the state already had suspicions. In other words, easy pickings. Once those are gone, it’s entirely possible the rate of fraud discovered will go down.


Apologies are in order to the Quinn administration.

Two weeks ago, we said in this column that the state Supreme Court had shot down Quinn’s move to eliminate money from the state budget to pay lawmakers until they approved pension reform. The administration was quick to point out that was incorrect and kindly shared its thoughts with us.

In fact, it was a lower court that handed Quinn his lunch on this. Quinn appealed to the Supreme Court, which hadn’t ruled when pension reform was approved a couple of weeks ago.

Since it was approved, Quinn is dropping the appeal. We’ll have to wait for another day to learn definitively whether a governor can take away salaries from lawmakers until they approve the bills he wants approved.

On a related note, Quinn didn’t collect his own salary while all of this was going on. When he cut lawmakers’ salaries, Quinn said he, too, wouldn’t take a paycheck until pension reform passed. By the time he signed the pension bill, Quinn had forgone about $70,000 of his salary.

Now that pension reform is law, Quinn is once again collecting his salary. Plus, he’s collected all of that back pay he was owed. Should be a happy holiday season in the Quinn household.