New Jersey Improperly Claimed Tens of Millions for Medicaid School-Based Administrative Costs Based on Random Moment Sampling That Did Not Meet Federal Requirements

As part of its oversight activities, the Office of Inspector General (OIG) is conducting a series of audits of Medicaid school-based costs claimed by States that used contingency fee contractors. In New Jersey, a prior OIG audit found that a contingency fee contractor made incorrect or unsupported changes to random moment timestudies used to calculate payment rates for Medicaid school-based health services. Because the contractor used similar timestudies to calculate Medicaid school-based administrative costs, we initiated this audit.