N.J. Admin. Code § 10:167E-5.8

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:167E-5.8 - Recoveries for benefits incorrectly paid

(a) The Department may take all necessary action to recover the cost of benefits incorrectly paid on behalf of a beneficiary.

1. The term "incorrect payment" includes, but is not limited to:

i. Payment made on behalf of a beneficiary whose hearing aid costs are wholly covered by another source;

ii. Payment made on behalf of a beneficiary who is no longer eligible, or has been incorrectly determined to be eligible to receive benefits; and

iii. Payment made as a result of fraud perpetrated by a beneficiary, his or her authorized agent and/or provider;

(b) The Department shall take all reasonable measures to ascertain the legal liability of third parties to pay for hearing aids arising out of injury, disease or disability, where it is known that a third party is or may be liable to pay all or part of the hearing aid costs for a beneficiary.

N.J. Admin. Code § 10:167E-5.8