New Jersey’s failure to use objective criteria in deciding hospitals’ Medicaid reimbursement has prompted an appeals court to order reopening of two dozen cases, in which $351 million is at stake.
In two rulings issued Feb. 22, Appellate Division Judges Judges Philip Carchman, Stephen Skillman and John Wallace Jr. found that the Division of Medical Assistance and Health Services had acted arbitrarily and capriciously by giving sparse and conclusory reasons for refusing to hear administrative appeals from reimbursement rate settings.
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