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) and the Division of Mental Health and Addiction Services (DMHAS), both 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 overpaid funds due to fraud, waste and abuse in the Medicaid program (often referred to as NJ FamilyCare).  This session is designed to provide stakeholders, specifically Medicaid partial care providers, 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 Medicaid State government agencies listed above, and New Jersey’s MCOs - Aetna Better Health of New Jersey, Amerigroup NJ, Horizon NJ Health, UnitedHealthcare Community Plan, and Wellcare. 

Registration for this event is closed.

For more information, please email provider-education@osc.nj.gov. The sponsors reserve the right to cancel or modify any training session for any reason without advance notice.