New Jersey Statutes 30:4D-55. Definitions relative to the Office of the Medicaid Inspector General
Terms Used In New Jersey Statutes 30:4D-55
- Department: means the Department of Human Services. See New Jersey Statutes 30:1-1
- Fraud: Intentional deception resulting in injury to another.
- person: includes corporations, companies, associations, societies, firms, partnerships and joint stock companies as well as individuals, unless restricted by the context to an individual as distinguished from a corporate entity or specifically restricted to one or some of the above enumerated synonyms and, when used to designate the owner of property which may be the subject of an offense, includes this State, the United States, any other State of the United States as defined infra and any foreign country or government lawfully owning or possessing property within this State. See New Jersey Statutes 1:1-2
- State: extends to and includes any State, territory or possession of the United States, the District of Columbia and the Canal Zone. See New Jersey Statutes 1:1-2
“Abuse” means provider practices that are inconsistent with sound fiscal, business, or medical practices and result in unnecessary costs to Medicaid or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care. The term also includes recipient practices that result in unnecessary costs to Medicaid.
“Department” means the Department of Human Services.
“Fraud” means an intentional deception or misrepresentation made by any person with the knowledge that the deception could result in some unauthorized benefit to that person or another person, including any act that constitutes fraud under applicable federal or State law.
“Investigation” means an investigation of fraud, waste, abuse, or illegal acts perpetrated within Medicaid by providers or recipients of Medicaid care, services, and supplies.
“Medicaid” means the Medicaid program established pursuant to P.L.1968, c.413 (C. 30:4D-1 et seq.) and the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C. 30:4J-8 et al.).
“Medicaid Fraud Control Unit” means the Medicaid Fraud Control Unit in the Department of Law and Public Safety.
“Office” means the Office of the Medicaid Inspector General created by this act.
L.2007,c.58,s.3.