New Jersey Did Not Suspend Medicaid Payments to Some Providers With Credible Allegations of Fraud in Accordance With the Affordable Care Act

The New Jersey Office of the State Comptroller, Medicaid Fraud Division, did not always suspend Medicaid payments to providers with credible allegations of fraud in accordance with the Affordable Care Act. Of the 49 providers with credible allegations of fraud that we reviewed, the Medicaid Fraud Division suspended or had good cause not to suspend Medicaid payments to 36 providers. However, it did not initiate proceedings to suspend Medicaid payments to the remaining 13 providers.