Bryant/Vitale Medicaid Inspector General Bill Clears Senate

TRENTON – A measure sponsored by Senators Wayne R. Bryant and Joseph F. Vitale, which would establish the State Office of Medicaid Program Integrity to help fight insurance fraud, received unanimous approval today in the Senate.

“The $900 million that the state loses each year as a result of Medicaid insurance fraud is an undue expense that taxpayers end up paying to help provide lower-income New Jerseyans with the health-care they need,” said Senator Bryant, D-Camden and Gloucester. “The new office would work to root out fraud and insurance abuse, and help ensure that the funding only goes to people who need it, not to those trying to defraud the State’s most vulnerable citizens.”

“In New Jersey, more than 1 million people go without adequate health insurance every day,” said Senator Vitale, D-Middlesex, the Chair of the Senate Health, Human Services and Senior Citizens Committee. “If we’re ever going to make an impact on the uninsured population of the Garden State, we need to ensure that our current health care resources are being utilized effectively and without abuse. The Medicaid Inspector General will go a long way towards accomplishing this end, providing necessary oversight and guaranteeing that our health care dollars go to those who need them most.”

The Senators’ bill, S-1852, would establish the Office of Medicaid Inspector General within the Office of the Inspector General and appropriate $3 million annually for office operations. The Medicaid Inspector General position would be responsible for identifying and rooting out fraud, waste and abuse within the Medicaid system, including recovering improperly expended funds and recommending persons found guilty of Medicaid related crimes to the State Attorney General for prosecution.

The Governor would be responsible for appointing the Medicaid Inspector General who would be a licensed attorney, and cannot have worked in the Medicaid system within the two years prior to appointment. The Inspector General would be responsible for issuing annual reports documenting audit and investigational findings, and recommendations for corrective actions.

The State Department of Human Services would still be responsible for the administration and supervision of the State Medicaid program.

After nearly a year-long review of the State’s Medicaid system, the Senate Budget and Appropriations Committee held a hearing on Medicaid fraud on March 14, 2006. During the hearing, the Committee heard testimony from State Medicaid Director Ann Kohler, Deputy Health and Senior Services Director Matt D’Oria, State Auditor Richard Fair and John Krayniak, Supervising Deputy Attorney General in the Medicaid Fraud Control Unit.

The bill was approved by the full Senate on December 14. Today’s vote reflects the approval of recommendations suggested by the Governor’s office. The measure now heads to the Assembly for consideration.

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