Improper Billing By Adult Day Care Centers
By Phil Gregory, WBGO News
Trenton. March 6, 2013
Investigators have uncovered a pattern of improper Medicaid billings at adult day care centers in New Jersey.
State Comptroller Matt Boxer says all five of the facilities examined were improperly billing for services they could not substantiate.
In some cases he says payments were made for services they could not possibly have provided.
“At one facility we found the state had been billed daily for more than a month for services provided to an individual who was actually away on vacation that entire time.”
Boxer says the failure to document whether essential medical services were actually performed raises concern about patient care.
“A review of patient records at one facility for example uncovered a consistent
failure to perform or document essential clinical and medical tasks such as monitoring blood sugar and blood pressure for patients who were attending the facility to they could receive those very services.”
Boxer is recommending more oversight of the facilities including random audits and site visits.
“We call on the industry itself to review the findings from this series of investigations and use them as a springboard to better practices. The patients at each of these facilities as well as the taxpayers of this state deserve nothing less.”
Boxer is trying to recover more than $10 million in improper payments and is referring the findings to the Attorney General’s office for possible criminal charges.
There are 134 adult day care medical centers in New Jersey. The ones that were investigated are in Elizabeth, Linden, Northfield, Belleville and Lakewood. The facility in Lakewood has closed.