Current through Register Vol. 54, No. 7, April 4, 2022
The Division, and agents thereof, responsible for the administration of the
Personal Preference Program shall employ methods, including, but not limited
to, offering training, issuing written materials, etc., to identify situations
in which a case of fraud and/or abuse in the program may exist.
(b) Any suspected situation of a Medicaid
fraud or abuse should be reported immediately to the Division.
The Division shall refer to the Office of
State Comptroller, Medicaid Fraud Division (MFD), any situation(s) in which
there is valid reason to suspect that Medicaid fraud has or may have been
committed in accordance with N.J.A.C.
(d) Willful or knowing acceptance of provider
agency services by an applicant approved for participant-directed services,
shall constitute fraud and may result in program disenrollment.
N.J. Admin. Code §
N.J.R. 3993(a), effective