Corrective Action Plans

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Finding Number: 2023-041 Finding Name: Inadequate Process for Preparing ETA 2208A Special Report Finding Condition(s): The Illinois Department of Employment Security (IDES) does not have an adequate process in place to ensure the ETA 2208A special reports prepared for the Unemployment Insurance (UI)...
Finding Number: 2023-041 Finding Name: Inadequate Process for Preparing ETA 2208A Special Report Finding Condition(s): The Illinois Department of Employment Security (IDES) does not have an adequate process in place to ensure the ETA 2208A special reports prepared for the Unemployment Insurance (UI) program are complete and accurate. Name of Contact Person(s): • Linette Hughes, Budget Director – Illinois Department of Employment Security, Office of the Budget • Belinda Moreno, State Budget Manager – Illinois Department of Employment Security, Office of the Budget • Anna Hrynewycz, Federal Budget Manager – Illinois Department of Employment Security, Office of the Budget Corrective Action(s): The IDES hired additional budget staff to aid in compiling and checking the reports to ensure complete and accurate reporting. Additionally, the IDES created and approved written procedures for the completion of the reports. Proposed Completion Date: July 1, 2024 - Completed
Finding Number: 2023-040 Finding Name: Inadequate Process for Preparing ETA 9130 Financial Reports Finding Condition(s): The Illinois Department of Employment Security (IDES) does not have an adequate process in place to ensure that the ETA 9130 financial reports prepared for the Unemployment Insura...
Finding Number: 2023-040 Finding Name: Inadequate Process for Preparing ETA 9130 Financial Reports Finding Condition(s): The Illinois Department of Employment Security (IDES) does not have an adequate process in place to ensure that the ETA 9130 financial reports prepared for the Unemployment Insurance (UI) program are complete and accurate. Name of Contact Person(s): • Kelly McGrath, Manager of Accounting and Reporting – Illinois Department of Employment Security, Accounting and Reporting • Briant Coombs, Manager of Accounting Service – Illinois Department of Employment Security, Accounting and Reporting Corrective Action(s): The IDES’ accounting staff will review its reporting procedures and determined ways to improve its controls over its reporting preparation, reviews, and approvals. Furthermore, the IDES will hire additional staff to aid in the ETA 9130 reporting process. Additionally, the IDES will look for ways to strengthen its internal controls over multiple IDES departments to ensure the data is complete and accurate. Finally, the IDES anticipates that, in coordination with the Illinois Department of Innovation and Technology (DoIT), the IDES’ reporting tools will be improved and/or modernized. Proposed Completion Date: December 31, 2025
Finding Number: 2023-039 Finding Name: Failure to Complete UI BAM Case File Reviews Within Required Timeframes Finding Condition(s): The Illinois Department of Employment Security (IDES) did not complete the Benefit Accuracy Measurement (BAM) case file reviews in accordance with United States Depart...
Finding Number: 2023-039 Finding Name: Failure to Complete UI BAM Case File Reviews Within Required Timeframes Finding Condition(s): The Illinois Department of Employment Security (IDES) did not complete the Benefit Accuracy Measurement (BAM) case file reviews in accordance with United States Department of Labor (USDOL) requirements for the Unemployment Insurance (UI) program. Name of Contact Person(s): • Dureyl Tyson, Benefit Accuracy Measurement Unit Manager – Illinois Department of Employment Security, Quality Assurance and Compliance • Charles Young, Quality Assurance & Compliance Manager – Illinois Department of Employment Security, Quality Assurance and Compliance Corrective Action(s): The IDES’ BAM Unit has instituted two internal controls to help with timeliness of case completion. First, a weekly activity report introduced to show past due cases. This report shows all activities, letters generated to the claimants, employers, and any associated parties; interviews; follow up with any parties to complete necessary documents; and any adjudication needed for each case. This report allows the case manager to adequately review and make recommendations towards case completion. Second, the IDES instituted two types of reminders to monitor case completion. The first type of reminders introduced by the IDES are sent for any cases that are past due. Additionally, the IDES started sending reminders that are sent for any cases due the upcoming week along with any cases closed but that have not been reviewed by the case managers. Both the weekly activity reports and the reminds allow the BAM manager to see which investigators needed more guidance in completing their cases. These activities also showed the need to find coachable moments in each investigation to help with completion, such as, analyzing information, coding, and completing the summaries, etc. Proposed Completion Date: June 30, 2024 – Completed
Finding Number: 2023-038 Finding Name: Failure to Follow Established Procedures to Determine Beneficiary Eligibility Finding Condition(s): The Illinois Department of Employment Security (IDES) failed to follow established policies when making eligibility determinations for claimants of the Unemploym...
Finding Number: 2023-038 Finding Name: Failure to Follow Established Procedures to Determine Beneficiary Eligibility Finding Condition(s): The Illinois Department of Employment Security (IDES) failed to follow established policies when making eligibility determinations for claimants of the Unemployment Insurance (UI) program. Name of Contact Person(s): Mireya Hurtado, Deputy Director of Service Delivery – Illinois Department of Employment Security, Service Delivery Bureau Corrective Action(s): Temporary Disabling of Certain IBIS Checks – Since April 16, 2024, all edit checks have been fully operational. Furthermore, the IDES has made procedural changes to address eligibility determination issues, including the establishment of regular health checks of the Illinois Benefits Information System (IBIS) system. Internal Controls Established to Ensure Timely Changes to UI Eligibility Procedures – In October 2023, the IDES resumed investigations of potential refusal of work issues. Additionally, all impact cross analyses were restored, as all online claim filing functionalities changed during the pandemic period. As of July 2025, the IDES had confirmed that the internal controls were in place and active. Established Monitoring Tools and Reports for Future Needs – As of March 31, 2025, the IDES established a report that allows the IDES to identify potential staff errors, the staff member in question, and the staff member’s home office. As of July 2025, the IDES ensured that key performance indicators were in place for service delivery, including Field Operations and the UI Program. Furthermore, the IDES had created the following internal controls: • Field Operations created a statewide Error Tracking spreadsheet that allows errors made on the claims and in adjudication to be reported to the appropriate regions/managers and allows errors to be assigned as tasks for the regions to work with the staff for correction and training. • UI Support managers frequently review the IBIS reports to spot check adjudication issues to ensure that they are being completed appropriately and review the End Date report to ensure that staff are using the appropriate end dates for their determinations. In addition, the IDES has daily reports that are scheduled to review that claims and adjudication issues are being handled correctly. • IDES developed a Quality Review process and report for Process Protest assignments, ensuring that protests are addressed appropriately. • Claims/adjudication dashboard is in development to further assist the IDES in this effort. Establish Training for Staff – The IDES is dedicated to ensuring that all areas have the training and resources needed to build upon current procedures and processes. To this end, the IDES is dedicating resources to develop and implement training. The agency has also realigned the Employee Engagement and Training Unit to Human Resources, where it can better identify individual employee training needs. As of July 2025, the IDES confirmed that a centralized training curriculum and system is in place for Field Operations, in collaboration with UI Program and other relevant business units within IDES. Furthermore, the IDES is conducting the following ongoing tasks: • The Service Delivery (SD) and the UI Training Team continues to update current training to ensure that the most up to date information is provided to staff. • The IDES is creating new training. An example is the Benefit Charging System (BCS) training for UI Revenue Analysts II. • The IDES is looking at common errors and confusing/difficult processes for staff, and prioritizing training to remedy those errors moving forward. • The IDES has added another UI Trainer. • SD (UI Program and UI Support managers) work alongside the training team to ensure the IDES dedicates the appropriate staff and adding more resources towards its training efforts Proposed Completion Date: June 30, 2025 – Completed
Finding Number: 2023-037 Finding Name: Failure to Report Subaward Information Required by FFATA Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) failed to report subaward information required by the Federal Funding Accountability and Transparency Act (FFATA) for awar...
Finding Number: 2023-037 Finding Name: Failure to Report Subaward Information Required by FFATA Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) failed to report subaward information required by the Federal Funding Accountability and Transparency Act (FFATA) for awards granted to subrecipients of the Crime Victim Assistance (CVA) program. Name of Contact Person(s): Greg Stevens, Director – Illinois Criminal Justice Information Authority, Federal and State Grants Unit Corrective Action(s): ICJIA received a similar audit finding in the FY22 audit (TO-50-24-11). In response, ICJIA initiated corrective action steps to address the FY22 and FY23 FFATA finding. ICJIA’s corrective actions included: • Developing a new internal procedure that assisted agency personnel in identifying awards and amendments subject to FFATA reporting requirements and report required subaward information in accordance with FFATA. Completed 12/31/24 • Developing a new policy/procedure that aligned with the newly developed procedure to include the preparation, review, and approval of FFATA reports. Completed 01/16/25 • Providing the policy and training to staff involved in preparing and submitting FFATA reports. Completed 02/03/25 • Ensuring all staff involved with managing federal grants have completed the DOJ-sponsored Grants Financial Management Online training. Completed 03/18/25 Proposed Completion Date: March 18, 2025 – Completed
Finding Number: 2023-036 Finding Name: Inadequate Controls over the Communication of Subrecipient Monitoring Results Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not consistently document supervisory reviews of the communication of on-site monitoring review r...
Finding Number: 2023-036 Finding Name: Inadequate Controls over the Communication of Subrecipient Monitoring Results Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not consistently document supervisory reviews of the communication of on-site monitoring review results in accordance with ICJIA’s control procedures. Name of Contact Person(s): Greg Stevens, Director – Illinois Criminal Justice Information Authority, Federal and State Grants Unit Corrective Action(s): ICJIA will revise its policies and procedures to incorporate expanded controls over the review of site visit reporting and grantee communications. Additionally, ICJIA will develop and provide training to staff on the updated processes. Proposed Completion Date: October 31, 2024 – Completed
Finding Number: 2023-035 Finding Name: Inadequate Fiscal Monitoring of Subrecipients Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not follow its established policies and procedures for monitoring subrecipients of the Crime Victim Assistance (CVA) program. Nam...
Finding Number: 2023-035 Finding Name: Inadequate Fiscal Monitoring of Subrecipients Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not follow its established policies and procedures for monitoring subrecipients of the Crime Victim Assistance (CVA) program. Name of Contact Person(s): Hemant Modi, Chief Fiscal Officer – Illinois Criminal Justice Information Authority, Office of Fiscal Management Corrective Action(s): ICJIA will update its risk assessment policy to provide more clarity on the monitoring procedures, including the additional factors used to prioritize audits, performed to ensure proper fiscal oversight. Proposed Completion Date: June 30, 2025 – Completed
Finding Number: 2023-034 Finding Name: Inadequate Review of Subrecipient Single Audit Reports Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not adequately review single audit reports received from its subrecipients for the Crime Victim Assistance Program (CVA)...
Finding Number: 2023-034 Finding Name: Inadequate Review of Subrecipient Single Audit Reports Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not adequately review single audit reports received from its subrecipients for the Crime Victim Assistance Program (CVA) program on a timely basis. Name of Contact Person(s): • Hemant Modi, Chief Fiscal Officer – Illinois Criminal Justice Information Authority, Office of Fiscal Management • Karen Crawford, Chief Grantee Auditor – Illinois Criminal Justice Information Authority, Office of Fiscal Management Corrective Action(s): By December 31, 2024, ICJIA hired and trained an individual to focus on the State’s Grant Accountability and Transparency Act (GATA) requirements over ICJIA’s reviews of its subrecipients’ single audit reports. Proposed Completion Date: December 31, 2024 – Completed
Finding Number: 2023-033 Finding Name: Failure to Adequately Monitor Subrecipients Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not follow its established program monitoring policies and procedures for subrecipients of the Crime Victim Assistance (CVA) progra...
Finding Number: 2023-033 Finding Name: Failure to Adequately Monitor Subrecipients Finding Condition(s): The Illinois Criminal Justice Information Authority (ICJIA) did not follow its established program monitoring policies and procedures for subrecipients of the Crime Victim Assistance (CVA) program for fiscal year 2023. Name of Contact Person(s): Greg Stevens, Director – Illinois Criminal Justice Information Authority, Federal and State Grants Unit Corrective Action(s): ICJIA will increase its headcount with 20 additional staff members to expand ICJIA’s monitoring capabilities of the Federal and State Grants Unit. Proposed Completion Date: June 30, 2025 – Completed
Finding Number: 2023-032 Finding Name: Failure to Report Subaward Information Required by FFATA Finding Condition(s): The Illinois Department of Public Health (IDPH) failed to report information required by the Federal Funding Accountability and Transparency Act (FFATA) for awards granted to subreci...
Finding Number: 2023-032 Finding Name: Failure to Report Subaward Information Required by FFATA Finding Condition(s): The Illinois Department of Public Health (IDPH) failed to report information required by the Federal Funding Accountability and Transparency Act (FFATA) for awards granted to subrecipients of the Immunization Cooperative Agreements (ICA) and the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) programs. Additionally, the IDPH not establish control procedures to submit FFATA reports for all subawards as required by federal regulations until June 2023. As a result, FFATA reports were not prepared or submitted for any subawards of the ICA and ELC programs for the period July 1, 2022, through May 31, 2023. Additionally, we noted that IDPH did not establish control procedures to submit FFATA reports for subawards as required by federal regulations for the period June 1, 2023, through June 30, 2023. Name of Contact Person(s): • Shelia Jefferson, Acting Deputy Director – Illinois Department of Public Health, Office of Performance Management • Timothy Stevens, Grant Management Auditor – Illinois Department of Public Health, Office of Performance Management Corrective Action(s): The IDPH’s Office of Performance Management (OPM) identified that there was a lack of compliance among grant managers in completing the required FFATA reporting and developed a Standard Operating Procedure (SOP) for FFATA reporting to address the gap and improve the process. The SOP was developed and tested from May through June 2023 and officially implemented in July 2023. The SOP was subsequentially enhanced on July 31, 2024, to accurately reflect obligation/action dates. The new process involved downloading all award information from the grant management system, the Electronic Grants Administration & Management System (EGrAMS), and having the OPM conduct a monthly batch upload of the data. When the policy was implemented, the IDPH ensured that all awards from fiscal year 2020 onward were reported, and that going forward, all subawards would be submitted within the required timeframe. Additionally, the OPM discovered that the obligation/action dates on the reports were being automatically generated based on the dates the signed Uniform Grant Agreements (UGA) were uploaded into EGrAMS, instead of the actual dates the agreements were signed. To correct this, the OPM worked with EGrAMS to add a field where grant managers would manually enter the dates the awards were signed when uploading the UGAs. Proposed Completion Date: July 31, 2024 – Completed
Finding Number: 2023-031 Finding Name: Inaccurate Special Report Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not maintain supporting documentation for key line items or prepare accurate special reports for the Low-Income Home Energy Assistance Progra...
Finding Number: 2023-031 Finding Name: Inaccurate Special Report Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not maintain supporting documentation for key line items or prepare accurate special reports for the Low-Income Home Energy Assistance Program (LIHEAP). Additionally, the DCEO has not established appropriate internal controls to ensure its quarterly reports submitted to USDHHS are properly supported in accordance with federal requirements. Finally, the DCEO’s supervisory review procedures have not been designed to operate at a level of precision to identify errors of the size and nature noted above. Name of Contact Person(s): Ben Moore, Fiscal Operations Manager – Illinois Department of Commerce and Economic Opportunity, Office of Community Assistance Corrective Action(s): The DCEO’s Office of Community Assistance (OCA) has implemented a process for an independent verification by a second OCA staff member of the correct data entry prior to submission of obligated funds for all future LIHEAP quarterly reports. Proposed Completion Date: February 25, 2025 – Completed
Finding Number: 2023-030 Finding Name: Failure to Communicate Award Information to Subrecipients Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not follow its established policies and procedures for monitoring subrecipients of the Low-Income Home Energy...
Finding Number: 2023-030 Finding Name: Failure to Communicate Award Information to Subrecipients Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not follow its established policies and procedures for monitoring subrecipients of the Low-Income Home Energy Assistance Program (LIHEAP). Name of Contact Person(s): Ben Moore, Fiscal Operations Manager – Illinois Department of Commerce and Economic Opportunity, Office of Community Assistance Corrective Action(s): There is currently a process in place to enter the correct Federal Award Identification Number (FAIN) from the federal award notice into the DCEO’s e-Grants system, which populates into all grant agreements created and issued for that grant series. To ensure the correct FAIN is entered, the Office of Community Assistance (OCA) added a step in its grant series establishment process to verify that the correct FAIN is entered into e-Grants prior to any grants being issued from that award. Proposed Completion Date: February 25, 2025 – Completed
Finding Number: 2023-029 Finding Name: Failure to Maintain Updated Procedures to File Subaward Information Required by FFATA Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) failed to maintain updated procedures which resulted in filing inaccurate Federal Fun...
Finding Number: 2023-029 Finding Name: Failure to Maintain Updated Procedures to File Subaward Information Required by FFATA Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) failed to maintain updated procedures which resulted in filing inaccurate Federal Funding Accountability and Transparency Act (FFATA) reports. Name of Contact Person(s): • Lisa Clement, Audit Liaison – Illinois Department of Commerce and Economic Opportunity, Office of Accountability • Megan Buskirk, Interim Chief Accountability Officer – Illinois Department of Commerce and Economic Opportunity, Office of Accountability • Phil Keshen, Deputy Director – Illinois Department of Commerce and Economic Opportunity, Office of Financial Management Corrective Action(s): The DCEO’s Office of Financial Management (OFM) will update the FFATA reporting procedures so reports are filed based on the award dates and to reflect that if grants’ values are equal or exceed $30,000 and are modified by any amount, they must be reported on again. Proposed Completion Date: August 1, 2025 - Completed
Finding Number: 2023-028 Finding Name: Failure to Perform Cash Draws in Accordance with the Treasury-State Agreement Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not perform its cash draws in accordance with the funding technique prescribed in the Tre...
Finding Number: 2023-028 Finding Name: Failure to Perform Cash Draws in Accordance with the Treasury-State Agreement Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not perform its cash draws in accordance with the funding technique prescribed in the Treasury-State Agreement (TSA). Name of Contact Person(s): • Lisa Clement, Audit Liaison – Illinois Department of Commerce and Economic Opportunity, Office of Accountability • Megan Buskirk, Interim Chief Accountability Officer – Illinois Department of Commerce and Economic Opportunity, Office of Accountability • Phil Keshen, Deputy Director – Illinois Department of Commerce and Economic Opportunity, Office of Financial Management Corrective Action(s): The DCEO’s Office of Financial Management (OFM) has requested that the Governor’s Office of Management & Budget (GOMB) change the funding technique for the Low-Income Home Energy Assistance Program within the Treasury-State Agreement to Pre-Issuance. This has been confirmed and will be in the agreement for fiscal year 2025. Proposed Completion Date: August 30, 2024 – Completed
Finding Number: 2023-027 Finding Name: Failure to Re-certify to the Accuracy of the Clearance Pattern Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not properly review or re-certify the accuracy of the clearance pattern specified in the Treasury-State ...
Finding Number: 2023-027 Finding Name: Failure to Re-certify to the Accuracy of the Clearance Pattern Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not properly review or re-certify the accuracy of the clearance pattern specified in the Treasury-State Agreement related to cash draws for the Low-Income Home Energy Assistance Program (LIHEAP). Name of Contact Person(s): • Lisa Clement, Audit Liaison – Illinois Department of Commerce and Economic Opportunity, Office of Accountability • Megan Buskirk, Interim Chief Accountability Officer – Illinois Department of Commerce and Economic Opportunity, Office of Accountability • Phil Keshen, Deputy Director – Illinois Department of Commerce and Economic Opportunity, Office of Financial Management Corrective Action(s): The DCEO’s Office of Financial Management (OFM) has requested that the Governor’s Office of Management & Budget (GOMB) change the funding technique for the Low-Income Home Energy Assistance Program within the Treasury-State Agreement to Pre-Issuance. This has been confirmed and will be in the agreement for fiscal year 2025. Furthermore, the OFM will develop policies and procedures to comply with the appropriate funding technique. Proposed Completion Date: August 30, 2024 - Completed.
Finding Number: 2023-026 Finding Name: Failure to Maintain Adequate Documentation for Reporting Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not maintain adequate documentation to substantiate the amounts reported on the Low-Income Home Energy Assista...
Finding Number: 2023-026 Finding Name: Failure to Maintain Adequate Documentation for Reporting Finding Condition(s): The Illinois Department of Commerce and Economic Opportunity (DCEO) did not maintain adequate documentation to substantiate the amounts reported on the Low-Income Home Energy Assistance Program (LIHEAP) Performance Data Form. Additionally, the DCEO has not established appropriate internal controls to ensure required data reports submitted to USDHHS are properly supported in accordance with federal requirements. Name of Contact Person(s): Ben Moore, Fiscal Operations Manager – Illinois Department of Commerce and Economic Opportunity, Office of Community Assistance Corrective Action(s): To avoid a similar loss of supporting documentation for federal reports, the DCEO’s Office of Community Assistance (OCA) will save a backup copy of all supporting documentation to ensure it is available for review after the report has been submitted. Proposed Completion Date: February 25, 2025 – Completed
Finding Number: 2023-025 Finding Name: Failure to Perform Reviews over Home and Community Based Waiver Services (HCBS) Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) failed to conduct utilization reviews over home and community-based services for five of the n...
Finding Number: 2023-025 Finding Name: Failure to Perform Reviews over Home and Community Based Waiver Services (HCBS) Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) failed to conduct utilization reviews over home and community-based services for five of the nine waivers contracted out to its vendor during fiscal year 2023. Name of Contact Person(s): • Pamela Winsel, Bureau Chief, Waiver Operations Management - Illinois Department of Healthcare and Family Services, Division of Medical Programs • Cynthia Mester, Public Service Administrator, Waiver Operations Management - Illinois Department of Healthcare and Family Services, Division of Medical Programs Corrective Action(s): The DHFS will procure a new vendor to complete record reviews for fiscal year 2026. Proposed Completion Date: December 31, 2025
Finding Number: 2023-024 Finding Name: Failure to Report Expenditures on the Medicaid CMS-64 Report in a Timely Manner Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not report certain Medicaid Cluster expenditures on quarterly federal financial (CMS-64) r...
Finding Number: 2023-024 Finding Name: Failure to Report Expenditures on the Medicaid CMS-64 Report in a Timely Manner Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not report certain Medicaid Cluster expenditures on quarterly federal financial (CMS-64) reports in a timely manner. Name of Contact Person(s): Jennifer Bourn, Bureau Chief – Illinois Department of Healthcare and Family Services, Federal Finance Corrective Action(s): The Illinois Department of Human Services (DHS) and the DHS’ Department of Innovation and Technology (DoIT) staff have implemented weekly reports on developmental disabilities (DD) waiver payment submissions to the DHFS to allow DHS staff information to review and timely identify any issues with the DD waiver submissions to the DHFS. The DHFS reviewed and revised its quarterly other agency Medicaid spending/federal revenue reporting, which is used to create the CMS-64. This report includes actual quarterly claim expenditure data and is distributed by the DHFS to other agencies and its staff for review each quarter. This report was redesigned to provide prior quarter/year comparisons to allow for more effective identification of problematic issues. Finally, the report’s recipient list was updated to ensure appropriate distribution to the DHFS’ staff and the other agencies. The DHFS’ staff follows-up with other agency recipients to ensure the quarterly reports are reviewed and responses are communicated to the DHFS. Proposed Completion Date: June 30, 2025 – Completed
Finding Number: 2023-023 Finding Name: Failure to Perform Recovery Audits over Medicaid Underpayments and Overpayment Claims Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not initiate any recovery audits over Medicaid claims during fiscal year 2023. Name ...
Finding Number: 2023-023 Finding Name: Failure to Perform Recovery Audits over Medicaid Underpayments and Overpayment Claims Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not initiate any recovery audits over Medicaid claims during fiscal year 2023. Name of Contact Person(s): • Ismaila Jagne, Administrative Assistant II - Illinois Department of Healthcare and Family Services, Office of Inspector General • Brian Dunn, Inspector General - Illinois Department of Healthcare and Family Services, Office of Inspector General Corrective Action(s): The DHFS’ Office of Inspector General and the recovery audit contractor (RAC) vendor developed and implemented an audit system. As the program’s administrator, the DHFS OIG monitors its efficacy on an on-going basis and will adjust as necessary. While the RAC vendor did work to complete 13 audits in fiscal year 2023, pursuant to a former contract, the DHFS did not execute its 2023 RAC contract until August 12, 2022. By law, no work could begin under that contract until it was finalized. Once the contract was executed, DHFS’ OIG began working with the vendor to develop the policies, procedures, templates, and systems needed to run an efficient and effective auditing program. The DHFS’ OIG and the RAC vendor met on a bi-weekly basis to develop and implement this system. After all planning and development was completed, the vendor programmed its system and auditing began. RAC audits have a three-year look-back period; therefore, audits in the system will cover fiscal year 2023. Proposed Completion Date: October 31, 2023 – Completed
Finding Number: 2023-022 Finding Name: Failure to Discontinue CHIP Benefits for Ineligible Individuals Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) improperly continued providing benefits under the Children’s Health Insurance Program (CHIP) program to indivi...
Finding Number: 2023-022 Finding Name: Failure to Discontinue CHIP Benefits for Ineligible Individuals Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) improperly continued providing benefits under the Children’s Health Insurance Program (CHIP) program to individuals who were over the age of 19 prior to the start of the federal Public Health Emergency for COVID-19 (PHE) on March 13, 2020. Name of Contact Person(s): • Jacqueline Myers, Bureau Chief - Illinois Department of Healthcare and Family Services, Division of Eligibility • Phronsie Spaulding, Audit Compliance - Illinois Department of Healthcare and Family Services, Division of Eligibility Corrective Action(s): The DHFS accepts this finding for the 19-year-olds identified as receiving assistance under the CHIP program prior to the onset of the federal PHE. Those receiving assistance during the PHE were allowable under the Centers for Medicare and Medicaid Services’ Award Letter. CHIP eligibility for 19-year-olds was not allowable 14 months following the end of the PHE. These cases were redetermined in the State's federally required Unwinding Plan for which additional staff were hired and trained. The DHFS continues to review eligibility determinations for effectiveness and create a plan of action. Current data, as of April 2025, supports the success of the plan as these cases have decreased by 98%. Proposed Completion Date: December 31, 2025
View Audit 366965 Questioned Costs: $1
Finding Number: 2023-021 Finding Name: Inadequate Procedures to Determine Provider Eligibility Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not adequately screen providers of the Children’s Health Insurance Program (CHIP) and the Medicaid Cluster program...
Finding Number: 2023-021 Finding Name: Inadequate Procedures to Determine Provider Eligibility Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not adequately screen providers of the Children’s Health Insurance Program (CHIP) and the Medicaid Cluster programs to ensure that Medicaid providers were not on the USDHHS Office of the Inspector General’s (OIG) List of Excluded Individuals/Entities (LEIE) at the time the vouchers for the related services performed were paid. Name of Contact Person(s): • Susie Brown, Assistance Bureau Chief - Illinois Department of Healthcare and Family Services, Provider Enrollment Services • Anthony Kolbeck, Bureau Chief - Illinois Department of Healthcare and Family Services, Provider Enrollment Services Corrective Action(s): The Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system is used by the DHFS for the enrollment and screening of CHIP and Medicaid providers. On a monthly basis, IMPACT automatically checks providers enrolled within IMPACT to the LEIE to verify the provider is not on the LEIE. The IMPACT system is updated through quarterly system releases. As part of the 1.6 quarterly release, the DHFS’ Provider Enrollment Services (PES) updated the system to address the monthly screening check box defect causing the issue. In the Lexis Nexis monthly job, as part of license information, the DHFS receives files from the American Board of Medical Specialties (ABMS), the Clinical Laboratory Improvement Amendments (CLIA), the Drug Enforcement Administration (DEA), and the NCPDP (National Council for Prescription Drug Programs (NCPDP) and other states (out-of-state license/medical license files). Only the corresponding license check boxes are checked for the provider. As an example, for a provider with an ABMS license, the corresponding ABMS check box would be checked. Furthermore, as part of sanction information, the DHFS receives a discipline file, which has the information from the Excluded Parties List System (EPLS), the LEIE, the Medicaid Services Administration (MSA), and other federal and state databases to ensure all are checked for active providers in a monthly batch. Proposed Completion Date: March 31, 2023 – Completed
Finding Number: 2023-020 Finding Name: Failure to Perform Periodic Audits of Encounter Data Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not perform periodic audits of the accuracy, truthfulness, and completeness of the encounter and financial data submi...
Finding Number: 2023-020 Finding Name: Failure to Perform Periodic Audits of Encounter Data Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not perform periodic audits of the accuracy, truthfulness, and completeness of the encounter and financial data submitted by, or on behalf of each Managed Care Organization (MCO) for the Children’s Health Insurance Program (CHIP) and Medicaid Cluster programs during fiscal year 2023. Name of Contact Person(s): • Amy Roberts, Program Reporting Compliance - Illinois Department of Healthcare and Family Services, Division of Medical Programs, Bureau of Managed Care • Rich Allen, Quality and Compliance Operations Manager - Illinois Department of Healthcare and Family Services, Division of Medical Programs, Bureau of Managed Care • Keshonna Lones, Bureau Chief - Illinois Department of Healthcare and Family Services, Division of Medical Programs, Bureau of Managed Care Corrective Action(s): The DHFS, in coordination with its External Quality Review Organization (EQRO), worked with the MCOs to conduct a validation audit of the MCOs and posted the final report on the DHFS Report Center line on September 28, 2023. The DHFS issued notices to the MCOs and required submission of GAAP/financial statement audits to be provided to the DHFS no later than July 31, 2023. The reports submitted by each MCO have been shared with the DHFS’ financial team for review. Additionally, the DHFS created a policy document for the encounter and financial three-year audit cycle. Proposed Completion Date: September 28, 2023 – Completed
Finding Number: 2023-019 Finding Name: Failure to Report Drug Rebates on the Medicaid CMS-64 Report in a Timely Manner Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not accurately report certain Medicaid Cluster program drug rebates on quarterly federal f...
Finding Number: 2023-019 Finding Name: Failure to Report Drug Rebates on the Medicaid CMS-64 Report in a Timely Manner Finding Condition(s): The Illinois Department of Healthcare and Family Services (DHFS) did not accurately report certain Medicaid Cluster program drug rebates on quarterly federal financial (CMS-64) reports. Name of Contact Person(s): Jason Rosado Timmerhaus, Bureau Chief – Illinois Department of Human Services, Budget and Cash Management Corrective Action(s): The DHFS has identified and implemented the programming necessary to omit the Medicare Part D drugs in August 2024. The DHFS continues to monitor quarterly variances within the drug rebates included in its CMS-64s. Proposed Completion Date: August 31, 2024 – Completed
Finding Number: 2023-018 Finding Name: Inadequate Monitoring of Subrecipients of the CSLFRF and ERA Programs Finding Condition(s): The Illinois Department of Human Services (IDHS) did not obtain and review periodic performance reports for subrecipients of the COVID-19 – Coronavirus State and Local F...
Finding Number: 2023-018 Finding Name: Inadequate Monitoring of Subrecipients of the CSLFRF and ERA Programs Finding Condition(s): The Illinois Department of Human Services (IDHS) did not obtain and review periodic performance reports for subrecipients of the COVID-19 – Coronavirus State and Local Fiscal Recovery Funds (CSLFRF) and the Emergency Rental Assistance (ERA) and programs. Name of Contact Person(s): Joseph Wellbaum, Chief Financial Officer – Illinois Department of Human Services Corrective Action(s): The IDHS will develop an organized process to ensure the availability of performance monitoring reports to comply with information requests. Proposed Completion Date: July 1, 2025 – Completed
Finding Number: 2023-017 Finding Name: Inadequate Process for Monitoring Interagency Program Expenditures Finding Condition(s): The Illinois Department of Human Services (IDHS) does not have an adequate process for monitoring interagency expenditures claimed under or used to meet maintenance of effo...
Finding Number: 2023-017 Finding Name: Inadequate Process for Monitoring Interagency Program Expenditures Finding Condition(s): The Illinois Department of Human Services (IDHS) does not have an adequate process for monitoring interagency expenditures claimed under or used to meet maintenance of effort (MOE) requirements of the Supplemental Nutrition Assistance Program (SNAP) Cluster, the Temporary Assistance for Needy Families (TANF), and the Child Care Development Fund (CCDF) Cluster programs. Specific issues noted included the following: • Program questionnaires describing internal control procedures for the CCDF program were not obtained by the IDHS from the Illinois Student Assistance Commission, the Illinois Board of Higher Education, and the Illinois Community College Board. Additionally, the program questionnaire describing internal control procedures for the TANF program was not updated for the period under audit by the Department of Children and Family Services, • Quarterly certification reports were not prepared during the period for the CCDF program by the Illinois Student Assistance Commission, the Illinois Board of Higher Education, and the Illinois Community College Board, and • The IDHS did not perform a detailed review of costs claimed from expenditures reported by any of the other State agencies to ensure they met the specific program requirements. The other State agencies do not necessarily know which federal program or maintenance of effort requirement the costs they are providing to the IDHS will be claimed or used and are not able to assess whether the costs are allowable. Further, the IDHS did not assess whether the expenditures reported by other State agencies were paid during fiscal year 2023 to ensure the amounts reported to the Illinois Office of the Comptroller (IOC) and used to prepare the schedule of expenditures of federal awards (SEFA) were cash basis expenditures. Name of Contact Person(s): Sarah Eves, Bureau Chief of General Accounting – Illinois Department of Human Services, Office of Fiscal Services Corrective Action(s): The IDHS’ Bureau of Federal Reporting (Bureau) will contact the program fiscal liaison for all major programs regarding the process of reporting and appropriate use of federal funds by other agencies. Furthermore, the Bureau will request quarterly certifications and program questionnaires for those agencies receiving funds from federal awards. Proposed Completion Date: March 31, 2025 – Completed
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