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Opinion 97-2
… of risks covered under the plan, without regard to age, sex, health status or occupation and such that refunds, rebates, credits or dividends based on age, sex, health status or occupation are not permitted" … officer" shall include any former school board member with twenty years or more service in such position. The total …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… status; and review health insurance bills to compare social security numbers of eligible persons with the local … divorce, changes in dependents, address or phone number change). Social Security Association Death Master …
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
To determine if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in the Medicare buyin program
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)
… of implementation of the five recommendations included in our initial audit report, Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (Report 2020-S-35 ). … program. Many Medicaid recipients are also enrolled in Medicare. Under the Medicare buy-in program (Buy-in …
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 … disadvantaged and/or have special health care needs. Many of the State’s Medicaid recipients are also enrolled in … To determine the extent of implementation of the six recommendations made in our …
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)
… actively monitor the efforts of the localities and the broker to remove Medicaid recipients from managed care … the Department add measurable performance standards to the broker agreement regarding timely removal of dual eligibles …
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
… released three reports that found more than $100 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 have been … released three reports that found more than $100 million in improper payments made by the Department of Health DOH for …
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 included in our initial audit … moved to Medicaid fee-for-service (FFS) because the cost of the managed care premiums generally exceeds the cost of … To assess the extent of implementation of the four recommendations included in our …
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-medicareUnified Court System Bulletin No. UCS-132
… To explain procedures for processing Judicial Supplemental Support Allowance payments. Affected Employees Judges of the … for this payment. Background The Judicial Supplemental Support Fund (date of inception November 1, 2007) provides … with up to $5,000 in payments for services and goods to support them in the performance of their judicial …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-132-judicial-supplemental-support-allowanceReducing Medicaid Costs for Recipients Who Are Eligible for Medicare (Follow-Up)
… for Recipients Who Are Eligible for Medicare (Report 2021-S-16 ). About the Program DOH administers the State’s … for Medicare are required to apply for Medicare as a condition of receiving Medicaid. When Medicaid recipients … saved $294.4 million on behalf of these recipients for clinic, inpatient, and practitioner claims that could have …
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)
… buy-in program to assist certain low-income people pay out-of-pocket Medicare expenses. Under the buy-in program, … $1.3 billion. Our initial audit report, which was issued on October 26, 2012, determined that, from March 2006 through … identified $569,000 in additional premiums that were paid on behalf of individuals who had died. Of the initial …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… of Health (Department) made Medicaid mainstream managed care premium payments on behalf of individuals who had … funded program that provides a wide range of health care services to those who are economically disadvantaged and/or have special health care needs. The Department administers the State’s Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyState Comptroller DiNapoli Releases State Audits
… in the initial audit report; however, further action is needed. State Education Department: HTA of New York Inc., … than 50,000 state contracts, visit www.openbooknewyork.com . The easy-to-use website was created by DiNapoli to …
https://www.osc.ny.gov/press/releases/2016/12/state-comptroller-dinapoli-releases-state-audits-1Reducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
… Purpose To determine the implementation status of the five recommendations made in our initial audit report, … audit objective was to determine whether the Department of Health (Department) took sufficient steps to control the Medicaid costs of recipients diagnosed with end stage renal disease (ESRD) …
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
… Care and Health and Recovery Plan premiums on behalf of dual-eligible individuals. The audit covered the period … 2021 through March 2022. About the Program The Department of Health (Department) administers the State’s Medicaid … are referred to as “dual-eligibles.” Additionally, many of the State’s Medicaid recipients receive their services …
https://www.osc.ny.gov/state-agencies/audits/2022/10/31/medicaid-program-excessive-premium-payments-dual-eligible-recipients-enrolled-mainstreamImproper 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.pdfIV.4.C General State Charges – IV. Accounting Codes - Uses and Descriptions
… on Federal and other dedicated revenue funds. SFS Account Title Description 60001 Accidental Death Benefits … units who enroll in the Dependent Care Advantage Account (DCAA) plan. 60010 Employee Ben Fund – Active … appropriations specifically provided for such costs. SFS Account Title Description 60149 Other Taxes and Assessments …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv4c-general-state-chargesDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… The state Department of Health (DOH) could have saved the Medicaid program as much … and struggling with day-to-day life should be informed of their Medicare eligibility, which could reduce their out-of-pocket expenses and may provide them with more options for …
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 … age 65 who meet ESRD Medicare eligibility requirements who do not apply for Medicare. We requested that SSA issue a … apply for Medicare. Follow up with recipients who do not apply for Medicare by implementing a process that: …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-disease