New Jersey told to repay $32M in Medicare claims

New Jersey told to repay $32M in Medicare claims
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The Obama administration is asking New Jersey to pay back $32 million in Medicare payments that didn’t comply with federal law.

The improper billing was detailed on Monday in a report by the inspector general for the Department of Health and Human Services.

In a random sample of 100 personal care claims, investigators found concerns with 17 of those claims. Those issues ranged from lack of documentation, lack of nursing assessment and no plan of care, according to the report.


The sample was a small fraction of the 18 million detailed claims submitted that period by 266 personal care agencies in New Jersey. In all, the state spent $787 million on the claims — about $400 million that was reimbursed from the federal government.

Personal care assistance — one of Medicare’s most costly areas — pays for services for the elderly, people with disabilities and people with certain medical conditions. Those services can include “bathing, dressing, light housework, medication management, meal preparation, and transportation,” according to the government’s definition.

Health officials in New Jersey disputed some of the findings, taking issue with the administration’s methodology.

It is the federal government's second review into New Jersey’s care services program since 2007, when investigators found a “significant number of services improperly submitted” for reimbursement.