Auditors with the federal government say the New Jersey owes the U.S. $145 million for incorrectly billed Medicaid services. Garden State officials dispute the charges, but service providers are worried.
Federal auditors, who randomly selected 100 claims out of millions sent in by the state of New Jersey, said they found 36 claims that did not comply with Medicaid guidelines. Based on those findings, they determined that New Jersey owes $145 million.
The New Jersey Department of Human Services disagrees with the audit’s findings.
The number is random, contends Dr. Debra Wentz who heads the New Jersey Association of Mental Health Agencies.
“To make such sweeping extrapolations does not seem to be either statistically sound, or a methodology that really correlates to reality, but rather to a need to meet certain targeted amounts that have been budgeted in the federal government to recapture on Medicaid fraud and abuse,” she said.
The audit report is currently being reviewed at the federal level.
While the numbers are not final, the potential multimillion-dollar debt has raised anxiety levels among New Jersey service providers, said Wentz.
“Any type of huge recapture of funds from the system is extremely alarming because it could put certain providers out of business,” she said.
Wentz says providers in New Jersey are asking the state for online updates of Medicaid billing requirements, which constantly change all the time.
The current federal audit findings are in addition to $35 million the U.S. says New Jersey owes for incorrectly billing mental-health services.