NJ recovers $132M in bogus Medicaid payments
By: Mike Davis
Asbury Park Press
USA today Network - New Jersey
TRENTON - More than $132 million in Medicaid funds was recovered from health care providers who inappropriately billed or received them, the Office of the State Comptroller announced on October 7. [2025]
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The 2025 fiscal year total represents an 11% hike over last year, [2024] when more than $119 million was recovered.
..... "OSC takes very seriously its responsibility to protect the integrity of New Jersey Medicaid," said Josh Lichtblau, director of the comptroller;s Medicaid Fraud Division. "Every dollar misspent is money that should have been going toward the care of some of our state's most vulnerable residents."
..... The Medicaid Fraud Division investigates cases in which Medicaid was inappropriately billed, such a claims where another state should have paid for coverage or a third-party insurer was responsible. Ten health care providers voluntarily notified the comptroller's office of receiving about $1.8 million inappropriate Medicaid payments.
..... Health care providers have self-reported nearly $10.2 million in inappropriate Medicaid payments since 2019. The comptroller's office does not seek a penalty when accepting self-disclosures, the office said.
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Medicaid fraud is among the main pursuits of the comptroller's office. About half of the comptroller's staff works in the Medicaid Fraud division, and Mediated fraud is a frequent subject of the office's investigation. in the last decade, the office has recovered more than $1 million in inappropriate payments.
..... In June, [2025] the comptroller ordered three nursing homes to repay more than $2 million in Medicaid funds after discovering they didn't meet minimum staffing requirements. And in 2023, the office found that 21 adult medical day care centers improperly billed Medicaid for nearly $950 million related to overpayment and duplicate services.
..... The comptroller's office also makes policy recommendations to prevent wasteful Medicaid spending. In 2021, the Department of Human Services implemented recommendation from the comptroller's office to prevent excessive lab testing without a clinical purpose. That new law saved the state about $102 million from April 2021 to April 2025, comptroller calculations show.