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Opinion 97-2
… and Duties (authority to provide health insurance coverage for former school board members) INSURANCE LAW, ARTICLE 47; … in a municipal cooperative health benefit plan for Part B Medicare premiums paid by the former school board … in the school district's local health insurance plan for Part B Medicare insurance premiums paid by the former …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… other things, the retirees may be: allowed a continuation of coverage for surviving spouses or certain other eligible persons for a period of time after the eligible retiree dies. required to … or their surviving spouses and dependents. An audit of 20 school districts revealed ten school districts who …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-monitoring-health-insurance-premiums-retireesMedicaid Program – Improper Payments of Medicare Buy-in Premiums for Ineligible Recipients
… Objective To determine if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in … buy-in program. The audit covered Medicaid payments for individuals enrolled in the Medicare buy-in program for … Program coverage on behalf of individuals who do not have a benefit eligibility period established in the Department’s …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-payments-medicare-buy-premiums-ineligible-recipientsImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… included in our initial audit report, Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (Report 2020-S-35 ). About the … Program coverage on behalf of individuals who do not have a benefit eligibility period – a date range for which the …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followMedicaid Payments Made Pursuant to Medicare Part C (Follow-Up)
… Purpose To determine the extent of implementation of the six recommendations made in our audit report, Medicaid Payments Made Pursuant to Medicare Part C (Report 2012-S-133). Background Medicaid provides health care services to …
https://www.osc.ny.gov/state-agencies/audits/2016/12/15/medicaid-payments-made-pursuant-medicare-part-c-followUnnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)
… the quality and utility of the Medicare eligibility data it uses and take action to improve data quality or develop …
https://www.osc.ny.gov/state-agencies/audits/2013/11/01/unnecessary-managed-care-payments-medicaid-recipients-medicare-followDiNapoli Finds Over $100 Million in Inappropriate Medicaid Payments
… million in improper payments made by the Department of Health (DOH) for the Medicare buy-in program, maternity care, and drug and therapy claims. Nearly $400,000 in premiums may … range of medical services to economically disadvantaged populations, including low-income children and their …
https://www.osc.ny.gov/press/releases/2021/11/dinapoli-finds-over-100-million-inappropriate-medicaid-paymentsExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… in our initial audit report, Excessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed … Medicaid program. Many Medicaid recipients are enrolled in Medicare and are referred to as “dual-eligibles.” … who appeared eligible for IB-Dual but were not enrolled in a timely manner. We found DOH’s rollout of IB-Dual did not …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andMedicaid Program – Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare
To determine whether the Department of Health Department took sufficient steps to control the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-reducing-medicaid-costs-recipients-who-are-eligible-medicareImproper Payments Related to the Medicare Buy-In Program (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations made in our audit report, … of Medicare buy-in program eligibility are made by the New York City Human Resources Administration and the …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followUnified Court System Bulletin No. UCS-132
… Purpose To explain procedures for processing Judicial Supplemental Support Allowance … 20, 2008 (Administration). There will be no direct deposit for this payment. Background The Judicial Supplemental … 1, 2007) provides judges with up to $5,000 in payments for services and goods to support them in the performance of …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-132-judicial-supplemental-support-allowanceMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… through New York State of Health (NYSOH), New York’s online health insurance marketplace, and the remainder were …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyReducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
… and helped them enroll, the Medicaid program could have saved as much as $146 million over the six-year audit … 2015. Furthermore, we estimated the Medicaid program could have saved as much as $69 million over the next three years … for Medicare; follow up with Medicaid recipients who do not apply for Medicare; and recover Medicaid claims paid …
https://www.osc.ny.gov/state-agencies/audits/2018/09/05/reducing-medicaid-costs-recipients-end-stage-renal-disease-followMedicaid Program – Excessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans
… recipients who became dual-eligible prior to the date the new IB-Dual rate became effective. Key Recommendations …
https://www.osc.ny.gov/state-agencies/audits/2022/10/31/medicaid-program-excessive-premium-payments-dual-eligible-recipients-enrolled-mainstreamState Comptroller DiNapoli Releases State Audits
… of Health (DOH) Medicaid Payments Made Pursuant to Medicare Part C (Follow-Up) (2016-F-16) An audit released in … have saved up to $69 million if it limited payments of Medicare Part C cost-sharing liabilities. The audit also identified several scenarios under which Medicare Part C cost-sharing liabilities were improperly …
https://www.osc.ny.gov/press/releases/2016/12/state-comptroller-dinapoli-releases-state-audits-1Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (2020-S-35)
To determine if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in the Medicare buy-in program.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-20s35.pdfDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… disease (ESRD) who meet certain eligibility requirements get the Medicare benefits to which they are entitled, … $69 million from 2016 to 2018, which includes $17 million in savings for counties and New York City. "New Yorkers … their entitlement to Medicare and taken steps to help get them enrolled, the Medicaid program could have saved as …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-state-missing-out-millions-medicare-payments-kidney-patientsMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… were diagnosed with ESRD. Medicaid recipients with ESRD are eligible for Medicare coverage if they receive regular … Retirement Board, or as a government employee; (2) are already receiving or are eligible for Social Security or Railroad Retirement Board …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-diseaseIV.4.C General State Charges – IV. Accounting Codes - Uses and Descriptions
IV4C General State Charges
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv4c-general-state-chargesMedicaid Program – Excessive Medicaid Payments to Federally Qualified Health Centers for Group Therapy Services
… Purpose To determine if Medicaid reimbursement rates for group therapy services provided by Federally Qualified … rates. With approval from the federal Centers for Medicare and Medicaid Services, the Department amended … FQHCs billed incorrect reimbursement rates on their claims for group therapy services. The FQHCs billed an approximate …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/medicaid-program-excessive-medicaid-payments-federally-qualified-health-centers-group