Did New Jersey overbill Medicaid for mental health services?

The state of New Jersey may owe the federal government up to $35 million for mental health services incorrectly billed to Medicaid.

Audit reports show the state might have charged Medicaid for services from providers without proper credentials, or for salary and overhead costs not eligible for Medicaid reimbursement.

Debra Wentz heads the New Jersey Association of Mental Health Agencies. She says the potential debt to the federal government could jeopardize mental health services as budgets are already tight.

Wentz says going forward, the state should provide better guidelines to service providers in terms of what they can bill for and how they have to document their services. “Most findings are ‘dotting the I’ type of lack of compliance rather than any fraud and abuse, so it’s just a question of being able to know of what to do and how to do it,” said Wentz.  For example, the state department of human services could post all of the information related to billing Medicaid on one website.

In response to the audit findings, New Jersey governor Chris Christie said accountants will have to review the numbers.  “Let’s face it, if we have been doing something that’s wrong then we have to pay the price for that,” said Christie. He added that he is not convinced that the state has done anything wrong in Medicaid billing.