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Opinion 97-2
… that bear on the issues discussed in the opinion. INSURANCE -- Health Insurance (authority to cover former school board members); … (municipal cooperative health benefit plans) -- Self-Insurance (municipal cooperative health benefit plans) … reimburse a former school board member for Part B Medicare insurance premiums paid by the former school board member …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… and school districts, employees have the option to receive health insurance coverage after retirement. Among … that the eligible person is still alive. You can also update any relevant personal information (marriage, divorce, … Service and may have an associated cost. Genealogical websites: Compare local records to death records reported to …
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 ensure accurate eligibility determinations and timely closure of Buy-in Program cases for ineligible individuals. …
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)
… Objective To assess the extent of implementation of the five … of our initial audit report, issued November 29, 2021, was to determine if Medicaid made improper Medicare premium … Medicare Buy-in Program credits from January 1, 2015 to November 30, 2020. We determined the Department had not …
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 our audit report, Medicaid Payments Made Pursuant to Medicare Part C (Report 2012-S-133). Background Medicaid … of the State’s Medicaid recipients are also enrolled in Medicare. Under Medicare Part C, also known as Medicare managed care or … in our audit report Medicaid Payments Made Pursuant to Medicare Part C Report 2012S133 …
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)
… initial audit report, Unnecessary Managed Care Payments for Medicaid Recipients With Medicare (Report 2010-S-75). … made premium payments to Medicaid managed care plans for Medicaid recipients who also had Medicare health insurance coverage, known as "dual eligibles." For the three-year audit period ended May 31, 2010, we …
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
… (DOH) for the Medicare buy-in program, maternity care, and drug and therapy claims. Nearly $400,000 in premiums may have … DOH for the Medicare buyin program maternity care and drug and therapy claims …
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 Care and Health and Recovery Plans (Report 2021-S-37 ). About the … disorders. Within MMC and HARP is the Integrated Benefits for Dually Eligible Enrollees Program (IB-Dual), which became …
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
… apply for Medicare. The Social Security Administration (SSA) determines Medicare eligibility and enrolls individuals. SSA also administers the Supplemental Security Income (SSI) … 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
… the $5,000 Judicial Supplemental Support Allowance based on their part-time percentage. Judges retiring on December … 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-allowanceImproper Payments Related to the Medicare Buy-In Program (Follow-Up)
… Annual Medicaid payments for the Medicare buy-in program total approximately $1.3 billion. Our initial audit report, … its oversight of local districts, and enhance Medicaid claim processing controls to ensure accurate payment of …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followReducing Medicaid Costs for Recipients Who Are Eligible for Medicare (Follow-Up)
… saved $294.4 million on behalf of these recipients for clinic, inpatient, and practitioner claims that could have … saved $190.3 million on behalf of 17,818 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-followMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… Managed Care Payments for Medicaid Recipients With Medicare (2010-S-75) Department of Health: Inappropriate …
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
… of Department of Motor Vehicles’(DMV) Licensing and Registration Systems (Follow-Up) (2016-F-15) An audit report …
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)
… in Medicare, Medicare becomes the primary insurer (payer) and Medicaid the secondary. As a secondary payer, rather than … pays the recipient’s Medicare premiums, deductibles, and coinsurance amounts, which allows for a significant … the recipients about their entitlement to Medicare and helped them enroll, the Medicaid program could have saved …
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
… from MMC and HARP and moved to Medicaid fee-for-service (FFS) because the cost of the managed care premiums generally … of deductibles and coinsurance that Medicaid would pay on FFS claims for dual-eligibles. In response to the coronavirus … as long as minimum essential coverage (e.g., Medicaid FFS) was maintained. Key Findings We identified over $194.1 …
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
… Mental Health. 60028 Health Insurance –Prescription Drug Active Employee State's contribution to the health … Rights Law (Executive Law Art. 15) and the Governor’s Office of Employee Relations under various collective … but before a final administrative or contractual award decision has been made. 60176 Administrative or Contractual …
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
… of their Medicare eligibility, which could reduce their out-of-pocket expenses and may provide them with more options … This could allow Medicaid to pay ESRD recipients' Medicare out-of-pocket costs, such as premiums and coinsurance. … about Medicare benefits and Medicaid's payment of Medicare out-of-pocket costs, and to actively assist recipients in …
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
… Purpose To determine whether the Department of Health took sufficient steps to control the Medicaid costs of recipients diagnosed with … To determine whether the Department of Health took sufficient …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-disease