Search
Opinion 97-2
… INSURANCE LAW, ARTICLE 47; GENERAL MUNICIPAL LAW, §§92-a, 119-o: A school district may not reimburse a former school … by article 47 of the Insurance Law. The plan provides that when a former school board member becomes eligible to … by the former board members 1 . Although section 92-a does not expressly authorize reimbursement to officers, …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… Among 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 contribute to the health insurance …
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
… Program The Department of Health (Department) administers New York’s Medicaid program. Many Medicaid recipients are … For the period January 1, 2015 through December 31, 2019, New York’s Medicaid program paid $8 billion in Buy-in 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)
… 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 …
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 … made in our audit report, Medicaid Payments Made Pursuant to Medicare Part C (Report 2012-S-133). Background Medicaid …
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)
… of implementation of the six recommendations included in our initial audit report, Unnecessary Managed Care … Medicare deductibles and coinsurance for the recipients in question, the net savings to Medicaid would have been … Medicaid managed care premiums occurred because of delays in posting recipients' Medicare data to eMedNY (Medicaid's …
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
… improper payments made by the Department of Health (DOH) for the Medicare buy-in program, maternity care, and drug and … York State Medicaid program is administered by DOH and is a federal, state, and local government funded program that … in termination or miscarriage; and $2.4 million was paid when the SMCP date of service preceded the birth by one to …
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)
… of implementation of the four recommendations included in our initial audit report, 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.” …
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)
… the Medicare Buy-In Program ( 2010-S-76 ). Background The federal government established the Medicare buy-in program to …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followUnified Court System Bulletin No. UCS-132
… 14, 2008 December 31, 2008 OSC Actions OSC has created a new Time Entry earn code to be used to pay this allowance: …
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
… As of August 2017, 4.4 million people were enrolled in mainstream managed care plans – about 2.5 million were … premiums) were paid to MCOs that were related through some form of ownership (such as parent, subsidiary, or affiliate) … and recorded in eMedNY, the Department’s Medicaid claim processing and payment system. Since June 2016, the …
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)
… 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 … Of the initial report’s five audit recommendations, one was implemented, three were partially implemented, 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.” … disorders. Within MMC and HARP is the Integrated Benefits for Dually Eligible Enrollees Program (IB-Dual), which became effective April 1, 2021. IB-Dual offers a special (lower) MMC and HARP premium rate for certain …
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
… actions were still needed. Department of Health (DOH): Overpayments to Managed Care Organizations and Hospitals for … to ensure they are made only for authorized contract purposes. Auditors concluded that, while ESD had … in place to evaluate foreign offices’activities against contract requirements. In a follow-up, auditors found ESD …
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
… certain eligibility requirements get the Medicare benefits to which they are entitled, according to an audit released … from 2016 to 2018, which includes $17 million in savings for counties and New York City. "New Yorkers dealing with … Medicaid recipients with ESRD and helps guide them on how to apply for and enroll in Medicare. In response to the …
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
… State statutes. These benefits are supported primarily by General Fund appropriations, and supplemented with revenue … payroll taxes. 60020 Fringe Benefit Escrow Fund Non-General payments to the Fringe Benefit Escrow Fund for …
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 the …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/medicaid-program-excessive-medicaid-payments-federally-qualified-health-centers-group