Review of Inpatient Hospital Claims Billed as Family Planning Under New Jersey's Medicaid Program

Executive Summary

New Jersey improperly received Federal Medicaid reimbursement for family planning claims because the State's electronic Medicaid claims system did not identify all claims for which a family planning service was performed with a non-family-planning procedure during a single inpatient hospital stay and because some hospitals did not properly complete sterilization consent forms. As a result, the State improperly received $163,000 in Federal Medicaid funds.