Tuesday, April 1, 2008

Wealthy People Enrolled in New Jersey Health Care Program for the Poor

This could hurt (politically) Vitale's call for universal healthcare in New Jersey. Already some Republicans are calling the state not proficient enough to run a state healthcare insurance program. While, sure fraud exists, I think it is important to note the fraud is from those over qualified from this program, not people who are qualified and are so-called "double dipping." Health Care for all is absolutely essential and because possible fraud is possible is no reason to stop the call for universal healthcare. This is what was found:

Wealthy people are enrolled in a state-run health care program for working poor families and criminal investigators are examining another state health program for the poor, according to new state audits that found shocking displays of wasted money.

An audit found:

• Some beneficiaries failed to report all income on NJ FamilyCare applications. Applicants authorize the program to match applications with their tax return, but the state isn't checking all tax files, allowing people with incomes of $295,000, $186,000 and $177,700 to enroll.

• About 13,000 NJ FamilyCare participants weren't sent renewal applications, though regulations require eligibility be determined annually. The audit found $43.1 million was paid to these participants from July 2005 to September without knowing if they remain eligible.

• The state failed to try to collect $4.6 million owed to NJ FamilyCare by 16,300 people.

• The state paid $2.1 million from July 2005 to December for medical equipment that should have been paid for by nursing facilities.

• The state is failing to monitor medical equipment providers. For example, it found a provider billed the Medicaid program $30,000 for 48,000 adult incontinence briefs, though the audit found only 10,000 briefs were purchased. Auditors said they've referred this and other examples to state criminal investigators.

• The state isn't properly calculating Medicaid reimbursements. For instance, auditors found the state paid $8,181 for a wheelchair that should have cost $5,705.

• The state spent $6.7 million in state and federal money more than was needed to rent oxygen equipment and buy adult incontinence briefs.

• The state, from July 2005 to December, sent as many as three blood pressure monitors to Medicaid patients, even though many come with warranties and are replaced for free by drug store chains. The audit found the state could have saved $100,000 by denying these claims.

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