New Jersey pays for Medicaid beneficiaries living in New York
Healthcare Auditing Weekly, August 5, 2008
The Office of Inspector General determined that New Jersey paid over $1 million on behalf of beneficiaries who were Medicaid-eligible and receiving Medicaid in New Jersey and in New York between July 1, 2005 and June 30, 2006.
These beneficiaries should not be eligible in both states at the same time, according to the OIG report. If a beneficiary moves from one state to another, his/her Medicaid coverage should end in the initial state. State programs should review and determine eligibility of beneficiaries at least every 12 months, according the report.
The OIG is recommending the New Jersey state agency work with the New York agency to share available Medicaid eligibility information to:
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Determine accurate beneficiary eligibility status
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Reduce the amount of payments (estimated to be $1,070,619 during audit period) made on behalf of beneficiaries residing in New York.
The New Jersey state agency concurred with the OIG’s recommendations.
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