Report Materials
Contrary to Federal requirements, Illinois did not
contribute an estimated $2.1 million to CMS on behalf of the State's
'full-duals' from January through October 2006. Full-duals are beneficiaries
who are eligible for both full Medicaid benefits and Medicare. Although
Medicare subsidizes the Part D prescription drug benefit for full-duals, each
State is required to make contributions.
The State made no contributions for 22 of the 300 sampled full-dual
beneficiary-months. Although the State's monthly Medicare Prescription Drug,
Improvement, and Modernization Act (MMA) file included full-dual information for
18 of the 22 beneficiary-months, CMS did not include the information in the MMA
return file that identifies the amount billed to the State. For the remaining
four beneficiary-months, the State did not include full-dual information in its
MMA file, nor did CMS in its MMA return file. We recommended that the State (1)
work with CMS to develop a process for reconciling the MMA file to the MMA
return file to ensure that required contributions are identified and made for
all full-duals and (2) identify and accurately report all full-duals to CMS in
the MMA file. The State concurred with the recommendations.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.