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January 23, 2017

It’s no secret that medical bills in New Jersey can be sky high. Now it turns out that the Garden State is close to the top of the heap for another healthcare-related expense: Medicare overpayments. According to a new report from the Council for Medicare Integrity, New Jersey has the fourth-highest Medicare waste per beneficiary in the country.

The state overpaid $18.09 per Medicare beneficiary in 2015, the most recent year for which data is available. Given that 1,252,414 folks were signed up for the program, New Jersey shelled out $22,656,610 in total overpayments.

Medicare overpayments are generally made when a provider misbills the program for the services it provided to a patient, most often billing to a code that pays out at a higher rate than what’s approved.

“Medicare loses more money to improper payments than any other program government wide — more than $43 billion was lost from the program this way in FY2015 alone,” said Kristin Walter, spokesperson for the council.

Medicare trustees estimate that at current spending levels and with the expected influx of recipients, the program will be bankrupt by 2028.

CMI found that for the second year in a row, the District of Columbia ranked highest for Medicare overpayments per beneficiary, at $30.90. This is especially surprising because the District of Columbia has the nation’s smallest number of Medicare beneficiaries, according to the Centers for Medicare and Medicaid Services (CMS).

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