Bloomberg News

New Jersey Overbilled Medicaid $61 Million, U.S. Auditors Say

April 27, 2012

New Jersey is being asked to pay back $61 million in federal Medicaid reimbursements because the state hasn’t documented whether some services claimed for disabled people were provided, U.S. government auditors said.

The overbilling happened from 2005 to 2007 in a program that provides home care for mentally and physically disabled people so they don’t have to be institutionalized, auditors at the Health and Human Services Department’s Office of Inspector General said in a report today. The state billed the federal government $1.4 billion for the program during the period.

New Jersey and contractors it hired to provide the services “did not ensure that they claimed reimbursement only for documented, allowable” work, auditors said.

Work wasn’t documented for services such as respite care that New Jersey said it delivered to some patients, auditors said. The state also didn’t always follow federal procedures, including regular assessments of patients’ disabilities, according to the report.

The director of New Jersey’s Division of Medical Assistance and Health Services, Valerie Harr, who runs the state’s Medicaid program, asked auditors in October to recalculate what the state owed after providing additional documents, according to the report. Harr’s letter said that the state would owe $90 million.

A spokeswoman for Harr’s division, Nicole Brossoie, didn’t immediately offer a comment on the audit, sent to her by e-mail.

To contact the reporter on this story: Alex Wayne in Washington at awayne3@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net


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