The state is auditing state health plans to weed out ineligible participants receiving benefits.

Gov. Phi Murphy’s administration has begun an audit of participants in the government worker health benefits plans that it estimates will save the state $77 million.

Treasurer Elizabeth Muoio said Thursday the audit of staff and their dependents and spouses is underway to weed out participants who are no longer eligible for state-run health benefits or to pinpoint those who are already eligible for Medicare.

The state’s health care consultant announced a day earlier that plan premiums are expected to rise 6 percent for 2019, which Muoio said “underscored the need to enact these measures swiftly.”

“These initial measures are designed to exact savings through efficiencies in order to keep premiums in check while maintaining the same quality level of service for members,” she said.

The savings are in both future costs and in recovering the cost of medical claims paid on behalf of ineligible participants.

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Such audits are common in both the private and public sector to find children who may have aged out of the plans, spouses who may have divorced and employees who may have moved on without informing the insurer.

The state last audited its health care member rolls in 2009. At that time, the state sent letters to employees asking for income tax returns and other supporting documents to verify dependents are still eligible for coverage.

The administration at that time expected to find 10,000 to 15,000 ineligible dependents with $185 million in projected savings. It ultimately uncovered 36,600 enrollees who should not have been receiving benefits, resulting in $400 million in savings over five years, according to the treasurer’s office.

Treasury said it has kicked off this most recent audit by asking colleges and universities to …read more

Source:: New Jersey Real -Time News

      

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