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NJ Audit Finds Lax Medicaid Fraud Checking

A New Jersey government watchdog says a major insurance company did not do enough to root out Medicaid fraud.The state comptroller’s office says investigators with UnitedHealthcare’s Community Plan of New Jersey recovered $1.6 million in improper payments from its Medicaid health maintenance organization in 2009 and 2010.

That comes to less than $1 for every $1,000 in state and federal tax money put into the program to pay health costs for low-income people.

The report finds the company did not have enough fraud investigators and those on staff were not properly trained. Under the state’s Medicaid program, all four health maintenance companies are responsible for investigating fraud and abuse.

The state says United has made changes the audit calls for, and is planning to make others.

 

(Copyright 2013 by The Associated Press.  All Rights Reserved.)

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