Federal Audit of New Jersey School-Based Medicaid Programs Seeks $300M in Paybacks

The federal Office of Inspector General (OIG) released audit findings of New Jersey’s school-based Medicaid programs in which they request the state refund over $300 million.

Specifically, OIG determined:

1. PCG, the state’s contractor, improperly altered school employees’ responses to timestudies to indicate that their activities were directly related to providing Medicaid services when the responses indicated the activities were unrelated;
2. New Jersey improperly incorporated into its payment rates more than $400 million owed to the school employees’ pension fund despite not having made scheduled payments to the fund in nearly 20 years; and
3. Salaries of some employees who did not provide health-related services were incorporated into the payment rates.
4. New Jersey did not maintain documentation related to the timestudies, which it used to identify the percentage of time personnel provided particular services.

Read a summary of the audit findings here…

Read the full report here, including New Jersey’s response to OIG’s findings…