LAC 113

LEGISLATIVE AUDIT COMMISSION

RESOLUTION NO. 113
Presented by Representative Mautino

WHEREAS, the Illinois Department of Public Aid administers the State of Illinois’ medical assistance program and has contracted since 1984 with the Delta Dental Plan of Illinois to provide dental care for Medical Assistance grant recipients;

WHEREAS, the dental care program provides services to over one million individuals in Illinois;

WHEREAS, the Department of Public Aid over $30 million to Delta Dental in Fiscal Year 1997 alone;

WHEREAS, a 1990 management audit of the Department of Public Aid’s contract with Delta Dental Plan of Illinois made 26 recommendations and found the Department did not have adequate documentation supporting key decisions for any of the contracts with Delta Dental, the Department had not closely monitored contract provisions or contractor performance, and had not documented that it is less expensive to contract this program than it would be to administer it on a fee-for-service;

WHEREAS, the current contract between the Department of Public Aid and the Delta Dental Plan expires May 1, 1998; therefore be it

RESOLVED, BY THE LEGISLATIVE AUDIT COMMISSION that the Auditor General is directed to conduct a management audit of the Department of Public Aid’s contracts with the Delta Dental Plan of Illinois, or any subsequent contractor; and be it further

RESOLVED, that the management audit shall include, but need not be limited to, the following determinations:

Whether the Department of Public Aid has addressed concerns expressed in the prior management audit and implemented the recommendations contained in the prior audit;

Whether the Department of Public Aid’s current contract provides the Department with adequate controls to effectively manage the performance of Delta Dental Plan of Illinois;

Whether the Department’s review of Delta Dental Plan of Illinois’ performance assessed compliance with all pertinent contract provisions, including the timeliness of claims processing and the disposition of claims denied for reimbursement;

Whether the fees paid by the State, under the terms of the current contract and any new contract, for dental care are reasonable;

Whether the manner of soliciting proposals for a new contract was adequate and in conformity with any applicable laws and prudent business practices; and

Whether the manner and basis of evaluating proposals for dental care was adequate and in conformity with any applicable laws and prudent business practices; and be it further

RESOLVED, that all State agencies, dental care contractors, including the Delta Dental Plan of Illinois, and any other dental care contractors, or other entities which may have information relevant to the audit, are directed to cooperate fully and promptly with the Office of the Auditor General in the conduct of the audit; and be it further

RESOLVED, that the Auditor General commence this audit as soon as possible and report his findings and recommendations upon completion in accordance with the provisions of the Illinois State Auditing Act.

Adopted this 20^th day of April, 1998.

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Senator Thomas J. Walsh
Cochairman

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Representative Julie A. Curry
Cochairman