Bryant : State Needs To Get Aggressive To Recoup Medicaid Funds

TRENTON – Senator Wayne R. Bryant today said he has learned the State could save at least $18 million annually in State tax dollars by properly classifying residents of community based group homes for the developmentally disabled as eligible for federal Medicaid support.

“We must be aggressive in recouping the Medicaid dollars currently being lost by failing to review and to properly classify our community based disabled residents,” Senator Bryant said. “I’m told a good estimate right now is that we stand to gain at least $18 million annually for the State with proper review and classification.”

Senator Bryant said a preliminary report by State Auditor Richard Fair indicates that as many as 50 percent of 1,240 recipients of community based care for the developmentally disabled were wrongfully declared ineligible for Medicaid reimbursements and were being supported instead by State tax dollars.

Under the Community Care Waiver Program, residents of community based homes can qualify for Medicaid funds that normally are provided only for residents of traditional, institutional-type care facilities.

In a recent partial sampling of the income and other qualifications required for Medicaid eligibility, half the residents of community based homes who were classified as ineligible were found to actually be qualified to receive federal Medicaid reimbursements, Senator Bryant said.

“These preliminary findings should serve as a wakeup call because these are real State dollars that could be saved at a time when we are in a deep fiscal crisis,” Senator Bryant said. “Plus, these federal dollars are just being lost to other States when, in fact, New Jersey deserves them.”

In addition, the State lost more than an estimated $3 million in reimbursements from Medicaid over the last three years because group home providers failed to submit necessary attendance records to the federal government, Senator Bryant said.

Senator Bryant urged officials of the Department of Human Services to “get aggressive” in properly assessing the classifications of all residents of community based homes so proper assessments can be made to Medicaid.

His comments were made in conjunction with the hearing by the Department on its budget request for the fiscal year beginning July 1 before the Senate Budget and Appropriations Committee.

“This matter involves proper procedures training and paper work to maximize our eligible funding,” Senator Bryant said.