A state audit shows New Jersey may be overpaying for Medicaid because the largest Medicaid plan in the state is allegedly not pursuing fraudulent claims aggressively enough, according to a Bloomberg Businessweek report.
Comptroller Matthew Boxer has said that Horizon NJ Health “needs to step up its efforts in investigating Medicaid fraud and abuse and recovering misspent Medicaid dollars,” according to the report.
HNJH recovered $188,207 in improper payments over the past two years — less than one-tenth of 1 percent of the $1.3 billion the state pays HNJN each year.
An HNJH spokesperson said the comptroller’s report “paints an inaccurate and misleading picture” of the company’s efforts to fight Medicaid fraud. The company also said its anti-fraud unit received a 100 percent score in previous state Human Services Department audits.
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