There are three million Medicaid Recipients in Illinois, including low-income families, foster children, pregnant women and the elderly.
One investigation looks into how privatizing the state’s health system for the poor has shifted hundreds of millions of dollars in profits to insurance companies, moving it away from frontline medical providers.
The four-month examination — including dozens of interviews and a review of thousands of previously unpublished documents — reveals a system largely bereft of government oversight in which for-profit insurance companies routinely deny, delay and reduce reimbursements to providers who treat Medicaid recipients.
A second investigation identified more than a dozen top-level Medicaid officials in Illinois who have current or recent financial ties to the giant insurance companies now managing the $16 billion per year taxpayers spend to provide medical care to people who cannot afford health coverage.
The state’s top health care official rejects the suggestion that taxpayer money is being mismanaged or that conflicts of interest are undermining the agency’s objectivity at a time when the COVID-19 pandemic is putting the state’s health care system under stress.
Illinois Department of Healthcare and Family Services Director Theresa Eagleson said all potential conflicts are disclosed and vetted, and officials with dual financial interests are required to recuse themselves from agency decisions that affect their bottom line.
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