Office of the State Comptroller announces recovery of millions of Medicaid dollars by encouraging providers to self-disclose overpayments

OSC’s self-disclosure process accounted for 15 percent of all Medicaid funds OSC identified for recovery between fiscal years 2019-2021

TRENTON – $6,477,342 has been or will be paid back to New Jersey’s Medicaid program, the Office of the State Comptroller (OSC) announced, due to OSC’s self-disclosure process. Self-disclosures enable Medicaid providers to notify OSC of any inappropriate Medicaid payments they received and pay them back.

Self-disclosures accounted for 15 percent of all improperly spent Medicaid dollars that OSC identified for recovery during fiscal years 2019-2021. OSC identified recoveries of $2,066,068 in FY2019, $3,738,450 in FY2020, and $672,824 in FY2021 due to self-disclosures.

“These numbers prove that OSC’s self-disclosure process is a valuable tool to combat fraud, waste and abuse in New Jersey’s Medicaid program,” said OSC’s Medicaid Fraud Division Director Joshua Lichtblau. “This process enhances OSC’s efforts to audit and investigate Medicaid providers and allows us to recover millions of dollars for the Medicaid program of overpayments that rightfully should be returned to the Medicaid program. We remind providers of their responsibility to reveal when they’ve been overpaid by Medicaid and strongly encourage them to avail themselves of this process.”

Health care providers are required to self-disclose Medicaid overpayments they receive within 60 days of identifying an overpayment. Failure to do so may result in imposition of penalties against the provider. Often providers discover overpayments through their internal review process or internal compliance reports.

OSC’s self-disclosure process encourages providers to investigate/audit and report matters that involve inappropriate Medicaid payments they received. Medicaid providers benefit by self-disclosing timely reported overpayments because, in such cases, OSC can forgive or reduce interest payments, extend the repayment time, and waive false claims penalties.

To learn more about OSC’s self-disclosure process, visit OSC’s website and click on “Medicaid Resources.”

If you have any information about Medicaid fraud, waste or abuse, file a complaint with OSC or call 1-888-937-2835.

The Office of the State Comptroller (OSC) is an independent State agency that works to make government in New Jersey more efficient, transparent and accountable. OSC is tasked with examining all aspects of government expenditures, conducts audits and investigations of government agencies throughout New Jersey, reviews government contracts, and works to detect and prevent fraud, waste and abuse in Medicaid.

Stay up-to-date with the latest from OSC by following us on Twitter, Facebook, LinkedIn, and on Instagram at @NewJerseyComptroller.

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