More than $51 million in Medicaid funds went to New Jersey for school-based services that did not comply with federal or state regulations, the inspector general’s office of the Department of Health and Human Services has concluded in an audit.
The office recommends in the May 23 audit that the state refund the money to the federal government and improve its monitoring of school-based health providers. An additional $1 million in money for transportation services is also under scrutiny, and the auditor recommends the state work with the federal government to resolve those issues.
Medicaid provides funding for schools for some health services that are offered in a school setting, such as speech therapy or nursing services.
The inspector general’s office audited a sample of claims made in New Jersey from July 1, 1998, through June 30, 2001. Of the 150 claims examined, 109 were questionable, the audit says. In some cases, there was no documentation that a health provider ordered the services. For others, there was no verification that the services were actually rendered. From the sample, the federal government extrapolated the amount it believes it overpaid the state.
New Jersey officials disputed that it owed that much money when it commented on a draft of the audit.The state is initiating its own review. State officials said they plan to improve New Jersey’s monitoring system for Medicaid.
