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   OIG Mission   
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The mission of the Office of Inspector General (OIG) is to prevent, detect and eliminate fraud, waste, abuse, misconduct and mismanagement in programs administered by Healthcare and Family Services and the Department of Human Services. The programs include Medicaid, KidCare, Temporary Assistance for Needy Families, food stamps, child care and other social services. The OIG's duties fall into several broad categories.

 

Duties of the Office of Inspector General:

  • Fraud Prevention: Recognizing that prevention is the first line of defense against fraud, the OIG uses a variety of techniques to deter fraud. The OIG employs advanced computer technology to research and detect trends that may lead to abuse. Other examples include pre-enrollment verifications for non-emergency transportation and durable medical equipment providers. The OIG also closely monitors selected providers to ensure services actually have been provided. Error-prone public assistance applications in Cook County are targeted to prevent ineligible persons from receiving welfare benefits.

  • Investigations: When a public aid client, employee or contractor is suspected of fraud or other misconduct the OIG investigates the matter. The OIG also works closely with local, state or federal authorities to develop cases for possible prosecution against medical providers.

  • Audits and Reviews: The OIG conducts several types of audits and reviews to ensure the integrity of Illinois' Medicaid Program. Post-payment compliance audits are performed to identify any improper payments which may have been made to Medicaid providers. Quality of care reviews are conducted to ensure proper care is being given to our clients by health care providers. Eligibility reviews are performed to ensure that only those clients eligible for Medicaid services receive them.

  • Sanctions and restrictions: The OIG acts against medical providers who violate Medicaid regulations or jeopardize the health and well-being of Medicaid patients. The OIG can sanction, suspend or terminate Medicaid providers and order repayment of state funds. The Recipient Restriction Program identifies Medicaid clients who excessively use health care services. For coordination of care, a client can be restricted to a single primary care physician and/or a single pharmacy for up to 24 months.

  • Safety and security: The OIG is responsible for protecting the well being of employees, clients and visitors at all Department of Public Aid facilities in Illinois. It oversees security at all facilities occupied exclusively by Public Aid staff.

   2012 Annual Report (PDF - 1503KB, EXE - 1343KB)

 

   2011 Annual Report (PDF - 1168KB, EXE - 421KB)

 

   2010 Annual Report (PDF - 479KB, EXE - 421KB)

 

   2009 Annual Report (PDF - 578KB, EXE - 580KB)

 
   2008 Annual Report (PDF - 483KB, EXE - 453KB)
 
   2007 Annual Report (PDF - 1.17MB, EXE - 513KB)
 
   2006 Annual Report (PDF - 1.56MB, EXE - 571KB)
 
   2005 Annual Report (PDF - 874KB, EXE - 483KB)
 

   2004 Annual Report (PDF - 1.57 MB , EXE - 1.52 MB )

 
   2003 Annual Report (PDF - 468KB, EXE - 309KB)
  • Data - 2003 Aggregate Billing Report (Not Available at this time)
 
   2002 Annual Report (PDF - 102KB, EXE - 117KB)
 
   2001 Annual Report (PDF - 367KB, EXE - 380KB)
 
   2000 Annual Report (PDF - 102 KB, EXE - 163KB)
 
   1999 Annual Report (PDF - 80KB, EXE - 119KB)
 
 

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