Public Sector

Despite ‘staggering’ success, Ill. drops Medicaid fraud finder -- gives job to unionized employees

Illinois is rewarding a private company that has found more than 200,000 people who should not be enrolled in Medicaid by pulling the firm off the job. 

Maximus, a Virginia-based company, has been combing through the 2.7 million people enrolled in Illinois' Medicaid program. 

So far this year, the company has reviews 465,067 cases, and recommended that 228,965 people - about half - be dropped from the Medicaid rolls. Illinois has removed 114,675 people from Medicaid, and kept 176,664. The remaining cases are pending. 

But Maximus' time on the job is coming to an end. 

A six-page memo from Oct. 31 states that the state's Healthcare and Family Services agency as well as the state's Department of Human Services will stop using Maximus and will turn over the Medicaid review to unionized public employees. 

"HFS and DHS are have determined that it is possible to make the process more efficient by eliminating the step of Maximus eligibility workers making a recommendation, so that the case goes directly to a State caseworker," states the letter from Michael Koetting, HFS' deputy director of Planning & Reform Implementation. 

The move satisfies the order of an arbitrator who ruled that public employees, most represented by the American Federation of State, County and Municipal Employees, are required to do the same job that Maximus has been successfully working at for more than a year. 

Click for more from