New Jersey Tightens Medicaid Billing Scrutiny on Disability Vendors
New Jersey's Department of Human Services has sharply increased scrutiny of Medicaid billing by "vendor" organizations that run add-on programs, such as art, fitness, and social skills classes, for disabled adults, according to the New Jersey Monitor. Starting last summer, the state began denying payment requests for some programs that had been reimbursed for years, with operators told their rates were too high or their programs not inclusive enough of the general public. Paid claims for these goods-and-services programs rose from $10.4 million in 2020 to more than $54.2 million last year, prompting the closer review, state officials said. The department says there is no policy change, only stricter enforcement of existing rules to protect Medicaid compliance and federal funding amid increased federal scrutiny of Medicaid spending; families and program operators say the denials have already cut off services for some disabled adults.