Audit finds $1M in overpayment on Medicaid billings

TRENTON – The state found $1 million in overpayments related to coding errors on Medicaid billings for injectable drugs, according to an audit released today.

In addition, the audit of the Department of Human Services, Division of Medical Assistance and Health Services, Medicaid Pharmacy Program, disclosed that $4 million could be saved if long-term care pharmacy claims were subjected to a proper review before dispensing.

The report by the state Auditor also disclosed 439 instances in which HIV/AIDS patients – Medicaid recipients –  received an additional two-month supply of medication in a given year. The audit said the 14-month supply of extra medicine totaled $648,000.

In its reply to the audit, the Department said it would implement better controls.

In addition, the Department pointed out that the proposed fiscal year 2013 budget includes a provision that review standards that are already applied to retail pharmacy claims also will be applied to the long-term care claims.

The audit covered July 2008 to February 2012.

Audit finds $1M in overpayment on Medicaid billings