New Jersey Claimed Medicaid Reimbursement for Adult Partial Hospitalization Services That Did Not Comply With Federal and State Requirements 

All 100 of the New Jersey Department of Human Services' (State agency) sampled claims for Federal Medicaid reimbursement for partial hospitalization services did not comply with Federal and State requirements, and 92 contained more than 1 deficiency. Partial hospitalization services are provided on a hospital-outpatient basis to adults with serious mental illnesses to prevent inpatient hospitalization and achieve community integration. On the basis of our sample results, we estimated that the State agency improperly claimed at least $30.7 million in Federal Medicaid reimbursement for partial hospitalization services that did not meet Federal and State requirements.