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MADISON - ST. CLAIR RECORD

Friday, March 29, 2024

U.S. Attorney goes after Medicaid fraud

An executive order signed by former Illinois Gov. Rod Blagojevich continues to cost state taxpayers hundreds of millions annually.

Early on during the disgraced governor's administration, Blagojevich granted state employment privileges to Medicaid assistants without the supervision that attaches to state jobs.

The rules guarantee abuse, for disabled persons can hire anyone but a spouse.

They can hire felons, abusers and sex offenders, U.S. Attorney Stephen Wigginton said at a July 11 conference on 15 indictments of assistants and beneficiaries.

“Every time we go fishing we catch something,” he said.

The state employs 27,000 to 28,000 assistants at $11.65 an hour, and for some it contributes to health care at 75 cents an hour. The state spent $593 million on assistants last year, Wigginton said.

He started investigating after an assistant fatally neglected a beneficiary.

Last year he indicted 14 assistants and beneficiaries, convicting all but one who died.

He said assistants and beneficiaries sometimes overcharge and split the money.    

His 29 indictments include 11 beneficiaries.

All assistants belong to Service Employees International Union or pay fair share dues if they choose not to join, Wigginton said. Assistants pay dues of three percent.

He said the state also provides the union with $2 million to hold training conferences but that attendance has been extremely low.

He said the state and the union signed a contract last Dec. 6.

“Six months after assistants and beneficiaries were indicted, they continued the program,” he said.

He said the union would get $2 million for training this year as far as he knew.

SEIU also was Blagojevich’s largest campaign contributor.

Wigginton called for legislative changes.

“This program has so many flaws that it needs to be addressed in a broad fashion and a speedy fashion,” he said. “There is very little supervision of the program, very little supervision of eligibility, very little supervision of payments."

He said he found ghost employees and beneficiaries.

“More often that not, family relationships are involved in fraud," he said. 

His press release stated that a stepmother claimed a stepson as her assistant for seven months he spent in jail.

He said people are deemed eligible if they are one step away from an institution, but he found many of them going about their daily business.

“They sure could walk right into the courthouse and understand,” he said.

He said the indictments involved amounts from about $5,000 to $100,000.   

Wigginton lined the walls with important people grimly nodding in agreement.

He introduced St. Clair County sheriff Rick Watson and thanked him for his work.

Watson said, “Until I saw pictures of the deceased, I didn’t know anything about this program.”

Wigginton said assistants have no incentive to encourage someone to be hospitalized.

“That cuts off the 11.65 an hour,” he said.

When a reporter asked about prospects for change in the Legislature, agent Gerald Roy of Health and Human Services in Kansas City stepped forward.

“We expect nothing less from the Legislature,” he said. "I am going to press this to Washington, D. C."

Wigginton’s press release stated that a woman in jail employed her boyfriend but turned him in because he wouldn’t post her bail with the proceeds.

It stated that a “no-show” assistant who had split money with a beneficiary turned in the beneficiary for choosing a different friend as her no-show.

The fraud charges carry maximum penalties of ten years and a $250,000 fine.

Blagojevich began serving a 14-year sentence in federal prison in March 2012, following his conviction for corruption including the soliciting of bribes for political appointments including the vacant U.S. Senate seat of President Barack Obama. 

 

          

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