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Opinion 97-2
… This opinion represents the views of the Office of the State Comptroller at the time it was rendered. The opinion … functions, powers and duties on a cooperative or contract basis. Fundamentally, a municipal corporation may … other things, for the regulation and certification by the State Superintendent of Insurance of "shared funding" …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… reimbursement checks and notification by the New York State and Local Employees Retirement System. It's important … and verify this information against a master eligibility list. Review Health Insurance Bills Ensure that health … may be governed by Rules and Regulations of the New York State Department of Civil Service (4 NYCRR Part 73). Updated …
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
… Medicare premium payments on behalf of recipients enrolled in the Medicare buy-in program. The audit covered Medicaid … determinations and timely closure of Buy-in Program cases for ineligible individuals. Review the active cases of Buy-in Program coverage for individuals without a …
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)
… by the Centers for Medicare & Medicaid Services (CMS), Medicaid pays Medicare premiums for individuals who … and process enrollment in the Buy-in Program. In addition, CMS automatically enrolls certain individuals. Medicaid … who were automatically added to the Buy-in Program by CMS with coverage beginning more than 2 years retroactively, …
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)
… in both Medicaid and Medicare Part C, plan providers bill Medicaid directly for the enrollee’s Part C cost-sharing …
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)
… six prior audit recommendations, three were implemented, two were not implemented, and one was no longer applicable. Key Recommendations None Other …
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
… in improper payments made by the Department of Health (DOH) for the Medicare buy-in program, maternity care, and … children and their families, seniors, and people with disabilities. As of March 2021, New York’s Medicaid … payments made for prescription drugs and therapy services. It found Medicaid paid $20.1 million for services that should …
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)
… Objective To assess the extent of implementation of the four recommendations … and/or substance use disorders. Within MMC and HARP is the Integrated Benefits for Dually Eligible Enrollees … should have been removed from their MMC or HARP plan and provided FFS coverage. Additionally, the audit found over …
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
… When SSA receives an SSI application for someone who is 65 years of age, it also checks the individual’s Medicare …
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)
… (Report 2021-S-16 ). About the Program DOH administers the State’s Medicaid program. Individuals who are eligible or … in response to the COVID-19 public health emergency. The State was required to restart this process and issue Medicaid …
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 … made in our audit report, Improper Payments Related to the Medicare Buy-In Program ( 2010-S-76 ). Background 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
… paid during the claims period are reimbursable. Each judge will automatically receive the three allowances (a maximum total of $2,500) unless a judge opts out of one or more of the allowances. Allowances … 31, 2007 and are prorated for part-time judges. Each judge will automatically receive reimbursement for State …
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
… premiums) were paid to MCOs that were related through some form of ownership (such as parent, subsidiary, or affiliate) …
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)
… to Medicare and helped them enroll, the Medicaid program could have saved as much as $146 million over the … December 31, 2015. Furthermore, we estimated the Medicaid program could have saved as much as $69 million over the next … how and where to apply for Medicare; develop an outreach program that encourages ESRD-related providers and …
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. However, recipients in MMC or HARP who enroll in Medicare but are not eligible for IB-Dual should be …
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
… Services Center within OGS as a centralized office for processing human resources and finance transactions that … of Health (DOH) Medicaid Payments Made Pursuant to Medicare Part C (Follow-Up) (2016-F-16) An audit released in … $28,952 in ineligible costs that HTA reported for state reimbursement, including $22,207 in other than personal …
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
… The state Department of Health (DOH) could have saved the … entitled, according to an audit released today by New York State Comptroller Thomas P. DiNapoli. Auditors estimate those … them with more options for care." DiNapoli said. "The state has an obligation not just to patients, but to …
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
… ESRD have been eligible for Medicare benefits. This allows state Medicaid programs to transfer some of the medical costs …
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
… includes the costs of providing fringe benefits to most State employees, which are authorized in collective … at various steps and arbitrations. A comprehensive list of definitions for terms used in this Section can be …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv4c-general-state-charges