The following state agencies -- the Medicaid Fraud Division (MFD) of the Office of the State Comptroller, the Division of Medical Assistance and Health Services (DMAHS) within the Department of Human Services, and the Medicaid Fraud Control Unit (MFCU) in the Attorney General’s Office -- work together with New Jersey's managed care organizations (MCOs) to identify and recover overpayments caused by fraud, waste, and abuse in the Medicaid program (often referred to as NJ FamilyCare). This session is designed to provide stakeholders, specifically Medicaid personal care agencies, with a better understanding of best practices to prevent, avoid, and detect fraud, waste, and abuse in the Medicaid program.

• The Medicaid program regulatory oversight structure
• The Medicaid regulatory framework and compliance requirements
• Medicaid documentation requirements for providers
• Third Party Liability (TPL) requirements
• Fraud, waste, and abuse obligations of providers (prevention and reporting)
• The consequences for non-compliance by providers

Representatives from the State government agencies listed above, and representatives from New Jersey’s Medicaid managed care organizations.

Registration is required and is limited to 500 participants.

Attendees are welcome to submit questions related to this training topic in advance.

Questions should be submitted to provider-education@osc.nj.gov by June 30, 2023. The team will do its best to address relevant questions throughout the course of the presentation.