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HB 4756

PUB AID RECOVERIES TRUST FUND

104th Regular Session Introduced by Graciela Guzmán and 1 co-sponsor

The bill allows using the Public Aid Recoveries Trust Fund to pay contingency fees to third-party auditors authorized by the OIG for recapture and related audits under the Public A

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Bill Summary · HB 4756

Summary of HB4756 (104th Illinois General Assembly)

Purpose and Intent

  • The bill amends the Illinois Public Aid Code to create and authorize disbursements from the Public Aid Recoveries Trust Fund specifically for paying contingency fees to third-party entities. These entities would conduct payment recapture audits and other specified audits under the medical assistance program, as authorized by the Office of the Inspector General (OIG).

Key Provisions and Changes

  • Public Aid Recoveries Trust Fund (Fund)

    • The Fund already exists to hold various sources of money related to public aid recoveries and related federal funds.
    • HB4756 clarifies and expands permissible disbursements from the Fund, including the new contingency fee payments to third-party entities for OIG-authorized audits.

  • Authorized Uses of the Fund (Disbursements)
    Disbursements from the Fund may be made for:

    1. Reimbursement of claims collected by the Department of Healthcare and Family Services (HFS) due to error or mistake.
    2. Payments to payees or co-payees on any instrument delivered to HFS as a recovery, proportional to each party’s interest.
    3. Payments to the Department of Human Services (DHS) for collections made on behalf of DHS under the Public Aid Code and related acts.
    4. Payment of administrative expenses incurred in performing authorized activities under the Public Aid Code and related acts.
    5. Payment of fees to persons or agencies for activities related to collecting monies owed to the State under the Public Aid Code and related acts.
    6. New item (6): Payment of contingency fees to third-party entities authorized by the OIG to conduct audits under Sections 12-4.25 and 12-4.40, or similar audits required by law.
    7. Payments reimbursable to the federal government that must be paid by State warrant.
    8. Payments to state universities, other state agencies, or local governmental entities of federal funds for services provided to eligible individuals under the applicable acts.

  • Funding and Appropriations

    • Disbursements for items (4) and (5) are subject to appropriations from the Fund.
    • After handling reimbursable federal amounts and anticipated needs for approved disbursements, the Fund balance is to be transferred annually (by June 30) to either:
    • The Drug Rebate Fund, or
    • The Healthcare Provider Relief Fund, as appropriate.
    • The Director of HFS may certify and the State Comptroller may transfer funds more frequently if needed.

  • Administration and Oversight

    • The contingency fee payments are tied to audits conducted by third-party entities that the OIG authorizes.
    • Audits referenced include those under Sections 12-4.25 and 12-4.40 of the Public Aid Code, and any similar audits required by state or federal law.

Who/What is Affected

  • State Agencies and Programs
    • Illinois Department of Healthcare and Family Services (HFS)
    • Department of Human Services (DHS)
    • State universities and other state/local entities involved in services for public aid recipients
  • Audit and Compliance
    • Office of the Inspector General (OIG) and third-party entities engaged to perform recapture and other audits
  • Financial Mechanisms
    • Public Aid Recoveries Trust Fund (Fund) and related funds (Drug Rebate Fund, Healthcare Provider Relief Fund)

Procedural and Timeline Aspects

  • Effective and Compliance Timeline
    • The legislative text indicates annual certification and transfer of Fund balances by the Director of HFS, with transfers to the Drug Rebate Fund or Healthcare Provider Relief Fund occurring on at least an annual basis by June 30 of each fiscal year. The Director may authorize more frequent transfers if appropriate.
  • Legislative Path
    • The bill has progressed through readings and committee action in 2026 and is listed with sponsor actions, indicating active consideration in both chambers.
  • Sponsorship
    • Primary sponsor: Rep. Norma Hernandez
    • Co-sponsors: Sen. Graciela Guzmán (Senate), Rep. Norma Hernandez

Potential Impacts

  • Auditing and Recoveries
    • Creates a formal funding stream to compensate third-party auditors (contingency fees) for successful payment recapture audits and related activities, potentially increasing focus on recapturing improper or erroneous payments.
  • Cost Sharing and Budgeting
    • Expands the uses of the Public Aid Recoveries Trust Fund to include contingent-based audit costs, subject to appropriation and annual balance management.
  • Program Integrity
    • Aims to strengthen compliance and recovery efforts within Illinois public aid programs, potentially improving federal and state recoveries.

If you’d like, I can provide a side-by-side comparison with current law to highlight all changes in plain language.

Compiled from official sources — confirm details with the bill’s official record.

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