Corporate Compliance

OIG: New Jersey needs to repay $6.6 million

Compliance Monitor, February 15, 2006

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The OIG has determined that New Jersey failed to report all overpayments in accordance with federal requirements, and now owes the feds $6.6 million. The state generally disagreed with the OIG's findings.

In a recent audit, the OIG determined the state

  • Delayed reporting overpayments until the date of its final decision or when it collected the overpayments in full

  • reported negotiated rather than gross overpayment amounts

  • recognized overpayments as of the date of the final rather than draft audit report

  • failed to return the federal share of overpayment interest collected from providers

    As a result, the OIG has recommended that the state

  • include unreported unreported overpayments totaling $13,242,420 ($12,279,902 not reported and $962,518 understated) on the CMS-64, and refund the $6.6 million federal share

  • determine the value of unreported overpayments identified after our audit period and report them

  • ensure that all overpayments are reported in accordance with federal requirements

      Click here to read the audit report, "Review of New Jersey's System for Medicaid Provider Overpayments," (A-02-04-01009) issued January 23, 2006.



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