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Opinion 97-2
… that bear on the issues discussed in the opinion. INSURANCE -- Health Insurance (authority to cover former … and Duties (authority to provide health insurance coverage for former school board members) INSURANCE LAW, ARTICLE 47; … in a municipal cooperative health benefit plan for Part B Medicare premiums paid by the former school board …
https://www.osc.ny.gov/legal-opinions/opinion-97-2Cost-Saving Ideas: Monitoring Health Insurance Premiums for Retirees
… review health insurance bills to compare social security numbers of eligible persons with the local government or … eligible persons. Simply crosscheck the social security numbers listed on the bill to those already identified as …
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
… premium payments on behalf of recipients enrolled in the Medicare buy-in program. The audit covered Medicaid payments for individuals enrolled in the Medicare buy-in program for the period from January 1, … 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)
… Department of Health (Department) administers New York’s Medicaid program. Many Medicaid recipients are also enrolled in Medicare. Under the … Program), administered by the Centers for Medicare & Medicaid Services (CMS), Medicaid pays Medicare premiums for …
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
… payments made by the Department of Health (DOH) for the Medicare buy-in program, maternity care, and drug and therapy … and claim costs totaled more than $68 billion. Improper Medicare Payments The first audit released today looked at Medicaid recipients who are also enrolled in Medicare. Under the Medicare buy-in program, Medicaid pays …
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)
… Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Report 2021-S-37 ). About the … Care (MMC), which provides comprehensive coverage, and Health and Recovery Plans (HARP), which provide specialized … from MMC and HARP as part of the COVID-19 public health emergency unwind process. Of the initial report’s four …
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
… control the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare. The … program. Individuals who are eligible or appear eligible for Medicare are required to apply for Medicare as a … 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-medicareUnified Court System Bulletin No. UCS-132
… Deadline for Receipt of Claims Paid on or About 1st Quarter 11/1/07– 1/31/08 February 15, 2008 March 31, 2008 2nd Quarter 2/1/08 – 4/30/08 May 16, 2008 June 30, 2008 3rd … 5/1/08 – 7/31/08 August 15, 2008 September 30, 2008 4th Quarter 8/1/08 – 10/31/08 November 14, 2008 December 31, …
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)
… extent of implementation of the five recommendations made in our audit report, Improper Payments Related to the Medicare Buy-In Program ( 2010-S-76 ). Background The federal government established … extent of implementation of the five recommendations made in our audit report Improper Payments Related to the Medicare …
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)
… audit report, Medicaid Program – Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare (Report 2021-S-16 ). About the Program DOH … audit report Medicaid Program Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare Report 2021S16 …
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
… 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-partyReducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
… disease (ESRD) who were eligible for, but not enrolled in Medicare. Medicaid recipients with ESRD may be eligible for Medicare coverage if they meet certain conditions. When Medicaid recipients are enrolled in Medicare, Medicare becomes the primary insurer (payer) 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
… from March 2021 through March 2022. About the Program The Department of Health (Department) administers the State’s Medicaid program. Many … throughout the public health emergency. In response, the Department paused disenrollment of dual-eligible recipients …
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
… to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up) (2016-F-8) < An audit issued in … potentially inappropriate Medicaid payments for low birth weight infants that did not meet billing requirements as well …
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.pdfIV.4.C General State Charges – IV. Accounting Codes - Uses and Descriptions
… a final judgment issued by a court, a settlement agreement reached by an agency and another party while a … proceeding, or proceeding under a collective bargaining agreement is pending, or a settlement agreement reached by an agency and another party without any …
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
… initiative to defray Medicaid program costs." Medicaid is a federal, state, and locally funded medical program that … Medicaid recipients with ESRD and helps guide them on how to apply for and enroll in Medicare. In response to the … enrollment of Medicaid recipients diagnosed with ESRD, as long as they met ESRD Medicare requirements. This could allow …
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
… renal disease who were eligible for, but not enrolled in, Medicare. The audit covered the period January 1, 2010 … with ESRD. Medicaid recipients with ESRD are eligible for Medicare coverage if they receive regular dialysis treatments … When Medicaid recipients with ESRD are also enrolled in Medicare, Medicare becomes the primary insurer (payer) and …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-disease