Memo Reveals Several Managers Knew of Medicaid Fraud in New Jersey Case

A state comptroller for New Jersey claimed that one of his employees acted of his own accord by discounting $2.6 million on how much certain fraudsters had to repay taxpayers for Medicaid. However, a new memo obtained by reporters indicates several levels of managers in the comptroller’s office knew about these deals, indicating an organized system of Medicaid fraud that could not be blamed on a single rogue worker.

The memo, written in 2017, contradicts Comptroller Philip J. Degnan’s claim that a single employee had overstepped his authority by slashing Medicaid paybacks by 50 percent. It was written by a former program supervisor and contains allegations that at least three managers — including one who served directly underneath Mr. Degnan — knew about the fraud. The memo also alleges the head of the office’s Medicaid Fraud Division even signed off on offering settlements.

The memo primarily dealt with an amnesty program offered by the comptroller’s office. The program had been controversial for some time. In 2017, 159 Ocean County residents sought amnesty after they reported receiving Medicaid benefits for which they were not eligible.

Denials from comptroller’s office

The comptroller’s office stated that all employees named in the memo deny having any conversations about such negotiations, and that internal investigations by the office did not result in any evidence other people knew the employee as offering Medicaid discounts.

Investigations revealed the employee was Andrew Poulos Jr., who worked for the state comptroller’s office from 2011 to December 12, 2017, the last day people were able to apply for the amnesty program. His job as supervisor of Medicaid fraud investigations was discontinued, according to public records.

The federal government takes a hard line against Medicaid and healthcare fraud. If you have information regarding such a fraudulent scheme, consult an experienced whistleblower attorney at Kardell Law Group to learn more about your legal options.