Inspector general challenges Illinois health system's budget practices

Cook County (Ill.) Inspector General Patrick Blanchard's office released an investigation report June 21 that challenges the finances and budget practices of Cook County Health system and its insurance program, according to the Chicago Tribune.

The health system and its insurance program, known as CountyCare, face a backlog of unpaid expenses, and unpaid bills have caused some healthcare providers to refuse service to those insured through the Medicaid-backed county insurance program, according to the report. The inspector general's report also notes that some contractors have placed Cook County Health's accounts on hold because of lack of payment, resulting in a shortage of pacemakers and anesthesia for surgeries.

The report found that CountyCare doesn't generate enough revenue to pay all outstanding healthcare expenses each fiscal year.

"[Cook County Health] has developed a practice of using subsequent period budgetary funds to pay prior period bills," the report states. "In effect, CountyCare is forced to pay substantial prior period and new period healthcare expenses during each fiscal period. Consequently, CountyCare's unpaid healthcare expenses are steadily growing and could become too large to pay without an extraordinary contribution from another funding source in the future."

The report also raises questions about some of the health system's bookkeeping practices, including an agreement that allows CCH and CountyCare to shift financial losses between them, according to WVIK. The health system also "routinely changes revenue and expense figures" between CountyCare and CCH's flagship medical center, John H. Stroger, Jr. Hospital "to reach desired financial goals," according to the report.

CCH rejected many of the inspector general's conclusions, and said officials need more time to review Mr. Blanchard's report.

"We are absolutely confident in the integrity of the program and will respond in a comprehensive manner in time," county health officials said in a statement to the Chicago Tribune.

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