Waltz Discusses Crack Down on State Medicaid Programs

Partner Judith Waltz is quoted in an article in Bloomberg BNA’s Health Care Daily Report, “Feds Cracking Down on State Medicaid Programs,” about an expected increase in federal scrutiny of state Medicaid programs after an audit of New Jersey’s Medicaid agency uncovered $54.7 million in improper reimbursements for partial hospitalization services.

Waltz said the audit should serve as a wake-up call to other states that have Medicaid-covered partial hospitalization services. She also said the New Jersey program will likely look to the hospitals to refund the deficient claims, which the audit recommends the state agency be required to reimburse the federal government for.

It’s increasingly likely that Medicaid programs in general will face greater scrutiny in the future than they have in the past, Waltz added. “Medicaid programs receive a lot of federal money, and there is a lot of talk about a need for Medicaid reform, which suggests more scrutiny for fraud, waste, and abuse,” she said.