The Office of the State Comptroller (“OSC”), Medicaid Fraud Division (“MFD”), in consultation with the Ocean County Prosecutor’s Office, today announces a pilot program that will enable Ocean County residents who believe they received Medicaid benefits improperly to withdraw from this program without fear of criminal prosecution.
Recipients who participate in the “Ocean County Recipient Voluntary Disclosure Program” (“Program”) will be required to repay Medicaid for the benefits they received while ineligible and pay an additional civil penalty, based on the amount of improperly received Medicaid benefits. Program participants also must voluntarily withdraw from Medicaid for a one-year period.
The Program will begin on September 12 and conclude on December 12, 2017.
Participants who fully satisfy the Program requirements will not be referred for criminal prosecution for Medicaid-related fraud for the period disclosed by the Program participant. The Ocean County Prosecutor’s Office affirms that it will not take action against Program participants who comply with the settlement terms.
“Our goal is to bring those in Ocean County who were not in compliance with Medicaid eligibility requirements into compliance and to have them make full restitution of all improperly received funds,” said State Comptroller Philip James Degnan. “Residents of Ocean County should consider this Program to be their best opportunity to come into compliance without fear of criminal prosecution.”
MFD Director Josh Lichtblau said, “in addition to bringing residents into compliance, this Program is beneficial because it will return Medicaid funds for use by New Jersey residents who truly are in need of assistance.”
To be eligible to participate in this voluntary Program, the person must:
- be an Ocean County resident;
- be or have been a recipient of Medicaid benefits;
- not have previously entered into a settlement with the OSC;
- not be the subject of a pending State or county criminal matter.
On Tuesday night, September 12, OSC will host a public meeting at which Ocean County residents can learn more about this voluntary Program. The meeting will be held at the Pine Belt Arena on the grounds of Toms River North High School, located at 1245 Old Freehold Road in Toms River, beginning at 6:30 p.m. Given the confidential nature of participation in this program, no recording devices, including cameras, will be permitted at the public meeting.
The Program application form and instructions, along with a sample Settlement Agreement, will be posted on the OSC web site, http://www.state.nj.us/comptroller.
Applications must be sent in no later than December 12, 2017.
An MFD representative will contact each applicant to obtain follow-up information (if needed), provide restitution and penalty information, and schedule a settlement appointment. Applicants (and their legal representative if they designate one) will then meet with MFD to sign a Settlement Agreement. Settlements will be referred to the State Department of Treasury-Office of Criminal Investigation to determine whether taxes are owed and the Social Security Administration to determine whether SSI benefits must be repaid.
MFD serves as the state’s independent watchdog for New Jersey’s various Medicaid programs and works to ensure that the state’s Medicaid dollars are being spent effectively and efficiently. As part of its oversight role, MFD audits and investigates health care providers, managed care organizations and Medicaid recipients to identify and recover improperly expended Medicaid funds and identify and redress quality of care issues affecting the health of Medicaid recipients.
Suspected Medicaid waste, fraud or abuse can be reported to the MFD by calling its toll-free hotline at (888)937-2835 or by submitting a complaint form located at the following address: http://www.state.nj.us/comptroller/divisions/medicaid/complaint.html.
Does this protect you from the IRS coming after you for tax fraud? Or can the IRS come after you based on the information given to the prosecutors office
Time to confess all your sins. It’s better than public arrest and prosecution.
Those that had hospital bills are going to have to pay back the costs that were paid for all medical care. That’s gona be a very heavy price. I hope that there aren’t many (if any) people that are in thus situation
It doesn’t help anyone if someone was ineligible to receive Medicaid because they made a few hundred or few thousand extra dollars where in the world are they going to get tens of thousands of dollars to repay Medicaid plus a fine??
For starters why in the world are they counting all medical bills as what was taken. They should look at the cost of an Insurance policy. That is what was possibly taken if one wasn’t eligible.
If the intention is to get people compliant it will only help if the amount that is asked for repayment is reasonable. To ask someone to repay such large amounts when their income very often may just be slightly over the threshold is only a way of saying, look we tried to help, when it really needs to be a lot more helpful.
For starters these programs need a phase out income eligibility to encourage people to get employed and not to have to be stuck on these programs.
Legislation needs to be created that private education dollars spent should not be considered in the income formula for these programs.
That alone would level the playing field a lot and put many more people in compliance.
Let’s face it people need to be able to eat and have insurance whether they have large families or choose to send to private education and the eligibility rules should reflect that.
You repay what you took illegally. If that amount is unreasonable, it’s not the government’s fault.
For some people this won’t help unless it’s in cooperation with snap and heap etc.
Y’shee’is HaShem Ke’hairef Ayin…
this is a huge chesed and in time for Elul. Luckily I am not impacted as I am low income and even get a house from it.
Why only Ocean County? What about the rest of the state?
Cuz they’re targeting Lakewood which is in ocean county
I hope this program contains a resource that allows people to demonstrate they acted in good faith and tried to find out if they were mistakenly non-compliant as well.
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