Search
Opinion 97-2
… members); (municipal cooperative health benefit plans) -- Self-Insurance (municipal cooperative health benefit plans) … in a municipal cooperative health benefit plan for Part B Medicare premiums paid by the former school board member. 1985 Opns St …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… and self-insured options and costs at regular intervals. If your experience rating and other factors are good, you may find comparable coverage at a lower cost. …
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 the … Program eligibility determinations and to prevent improper premium payments. During our audit scope: Medicaid made $31.7 million in improper Medicare premium payments on behalf of 42,586 individuals who did not …
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)
… report, Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (Report 2020-S-35 ). About the Program The Department of Health … program (Buy-in Program), administered by the Centers for Medicare & Medicaid Services (CMS), Medicaid pays …
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)
… Part C, also known as Medicare managed care or Medicare Advantage, private managed care companies administer Medicare … individuals enrolled in both Medicaid and Medicare Part C, plan providers bill Medicaid directly for the enrollee’s Part … paid the entire cost-sharing liability billed by a provider, regardless of the amount requested. Our initial …
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)
… For the three-year audit period ended May 31, 2010, we identified about 271,000 unnecessary Medicaid managed care … to remove Medicaid recipients from managed care programs when they become Medicare eligible, and to increase its … and to implement procedures to help ensure that Medicaid does not pay managed care premiums for enrollees of the …
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
… provides critical health care services to millions of New Yorkers but the program is dogged by oversight problems … mistakes don’t end up costing taxpayers.” The New York State Medicaid program is administered by DOH and is a … paid by Medicare. The payments included $18.6 million for physical, occupational, and speech therapy services, and $1.5 …
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)
… Medicaid program. Many Medicaid recipients are enrolled in Medicare and are referred to as “dual-eligibles.” … rates for Medicaid recipients in MMC or HARP who enroll in Medicare and do not need long-term services and support. … fee-for-service (FFS) because the cost of the managed care premiums generally exceeds the cost of deductibles and …
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
… the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare. The audit covered the period July 2016 through June …
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-reducing-medicaid-costs-recipients-who-are-eligible-medicareReducing Medicaid Costs for Recipients Who Are Eligible for Medicare (Follow-Up)
… Medicaid Costs for Recipients Who Are Eligible for Medicare (Report 2021-S-16 ). About the Program DOH … Individuals who are eligible or appear eligible for Medicare are required to apply for Medicare as a condition of …
https://www.osc.ny.gov/state-agencies/audits/2025/08/13/reducing-medicaid-costs-recipients-who-are-eligible-medicare-followImproper Payments Related to the Medicare Buy-In Program (Follow-Up)
… Purpose To determine the extent of implementation of the five … Medicare expenses. Under the buy-in program, Medicaid pays the Medicare premiums and sometimes the deductibles and …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followUnified Court System Bulletin No. UCS-132
… 2008 (Administration). There will be no direct deposit for this payment. Background The Judicial Supplemental Support … February 15, 2008 March 31, 2008 2nd Quarter 2/1/08 – 4/30/08 May 16, 2008 June 30, 2008 3rd Quarter 5/1/08 – 7/31/08 … 31, 2008 OSC Actions OSC has created a new Time Entry earn code to be used to pay this allowance: JSA Judicial …
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
… managed care premium payments on behalf of individuals who had comprehensive third-party health insurance coverage. … The Department administers the State’s Medicaid program. For the State fiscal year ended March 31, 2017, New York’s … totaled about $58 billion. Under managed care, Medicaid pays managed care organizations (MCOs) a monthly premium for …
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)
… Medicaid Costs for Recipients With End Stage Renal Disease (Report 2015-S-14 ). Background We issued our initial … costs of recipients diagnosed with end stage renal disease (ESRD) who were eligible for, but not enrolled in …
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
… Medicaid program. Many Medicaid recipients are enrolled in Medicare and are referred to as “dual-eligibles.” … premium rate for certain Medicaid recipients who enroll in Medicare and do not need long-term services and support. … and HARP plans who are ineligible for IB-Dual, or who opt out, and provide them with FFS coverage. Review the $194.1 …
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
… certain services it provides to its customers. Procurement card rebates have increased by over $4 million, and interest … by $34 million annually. Department of Health (DOH) Medicaid Payments Made Pursuant to Medicare Part C … An audit released in May 2014 found the state’s Medicaid program did not have limitations on the amounts it …
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, … Medicaid recipients with ESRD and helps guide them on how to apply for and enroll in Medicare. In response to the … in applying for Medicare; Follow up with recipients who do not apply for Medicare by implementing a process that …
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
… entitlement to Medicare and taken proactive steps to help get them enrolled, the Medicaid program could have saved as … Medicaid recipients with ESRD and helped guide them on how to apply for and enroll in Medicare. In response to our … age 65 who meet ESRD Medicare eligibility requirements who do not apply for Medicare. We requested that SSA issue a …
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
… pursuant to collective bargaining agreements. 60004 Dental Insurance State’s contribution to the Dental Insurance plan. … corporation indemnified by the state. 60182 Property Casualty Insurance Security Fund Transfer to the Property Casualty Insurance Security (PLIS) Fund in accordance with …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv4c-general-state-charges