Five N.J. adult centers improperly billed Medicaid by $10 million, comptroller finds

New Jersey investigators have uncovered a pattern of improper Medicaid billings at adult day-care centers.

 

State Comptroller Matt Boxer says all five of the facilities examined — including one in Northfield, South Jersey — were improperly billing for services they could not substantiate. In some cases, he says, payments were made for services they could not possibly have provided.

“At one facility we found the state had been billed daily for more than a month for services provided to an individual who was actually away on vacation that entire time,” Boxer said Wednesday.

Boxer says the failure to document whether essential medical services were actually performed raises concern about patient care.

“A review of patient records at one facility for example uncovered a consistentfailure to perform or document essential clinical and medical tasks such as monitoring blood sugar and blood pressure for patients who were attending the facility so they could receive those very services,” he said.

He’s recommending more oversight of the facilities — including random audits and site visits.

Boxer is trying to recover more than $10 million in improper payments and is referring the findings to the state attorney general’s office for possible criminal charges.

The other facilities are located in Elizabeth, Edison and Belleville. A fifth one in Lakewood has closed.