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Madrid-Waddington Central School District - Claims Audit Process (2019M-1)
… to audit. The claims auditor did not audit and approve any of the District’s health insurance claims and Medicare …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1Medicaid Program – Cost Saving Opportunities on Payments of Medicare Part C Claims
… be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with federal … to how New York Medicaid currently pays Medicare Part B cost-sharing. We project that, using this reimbursement …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-cost-saving-opportunities-payments-medicare-part-c-claimsMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… Purpose To determine whether the Department of Health's eMedNY system processes Medicaid claims for … by Medicare. Enhance existing eMedNY edits or implement new edits to detect any improper claim for ancillary …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientImproper Payments of Medicare Buy-In Premiums for Ineligible Recipients (2020-S-35) 180-Day Response
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-response.pdfMedicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… is appropriately applying the administrative costs in determining mainstream managed care premium rates. Our … pharmacy benefits, and many others. Of the $53 billion in Medicaid costs, MCOs received $17.8 billion in mainstream … managed care premium rates, which are based, in part, on allowable MCO administrative costs. For this purpose, the …
https://www.osc.ny.gov/state-agencies/audits/2016/10/13/medicaid-program-mainstream-managed-care-organizations-administrative-costs-used-premiumNew York State Comptroller Thomas P. DiNapoli Statement on Federal Tax Reform
… tax bill moving forward in Congress remains a bad deal for New York. "The cap on state and local tax deductions would … for many New Yorkers. "The legislation will drive up the cost of borrowing for state and local governments' capital …
https://www.osc.ny.gov/press/releases/2017/12/new-york-state-comptroller-thomas-p-dinapoli-statement-federal-tax-reform-0Medicaid Program – Medicaid Payments Made Pursuant to Medicare Part C
… the coinsurance. In addition, we determined Medicaid made $1.6 million in overpayments for Medicare Part C cost-sharing … including a review of other states' policies. Review the $1.6 million in Medicaid payments for Medicare Part C … Services to Recipients Receiving Medicare Benefits (2009-S-64) … To determine if Medicaid made excessive payments for …
https://www.osc.ny.gov/state-agencies/audits/2014/05/09/medicaid-program-medicaid-payments-made-pursuant-medicare-part-cDiNapoli: Medicaid Audits Find Nearly $800 Million in Savings and Revenue
… services to individuals who are economically disadvantaged or have special health care needs. For the State Fiscal Year … long-term care services to people who are chronically ill or disabled. Medicaid pays MLTC plans monthly managed care … either were only eligible for partial Medicaid benefits or did not have any Medicaid coverage; $269,478 in payments …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-medicaid-audits-find-nearly-800-million-savings-and-revenueState Agencies Bulletin No. 1513
… Taxable travel reimbursements include: Excess Personal Car Mileage (PCM) Reimbursements Excess Per Diem Payments … Federal per diems for the continental U.S. can be found in the Guide to Financial Operations Chapter XIII Section 4.E …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1513-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1434
… Taxable travel reimbursements include: Excess Personal Car Mileage (PCM) Reimbursements Excess Per Diem Payments … Federal per diems for the continental U.S. can be found in the Guide to Financial Operations, Chapter XIII, Section …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1434-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1356
… Purpose To provide agencies with the 2014 calendar year-end … business expense reimbursements require withholding and Form W-2 reporting on any excess amounts paid. “Excess amount” is …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1356-year-end-procedure-taxable-employee-expense-reimbursementsOverpayments of Certain Medicare Crossover Claims
… determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify … Background Many Medicaid recipients are also eligible for Medicare, the federal health insurance program available … are commonly referred to as "dual eligible." In general, for dual eligible individuals, Medicare is the primary claims …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsState Agencies Bulletin No. 1596
… business expense reimbursements require withholding and Form W-2 reporting on any excess amounts paid. “Excess … Federal per diems for the continental U.S. can be found in the Guide to Financial Operations, Chapter XIII, Section … Meal Allowances and One-Year Rule can be found in the Guide to Financial Operations, Chapter XIII, Section …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1596-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1674
… business expense reimbursements require withholding and Form W-2 reporting on any excess amounts paid. “Excess … Federal per diems for the continental U.S. can be found in the Guide to Financial Operations Chapter XIII, Section … Meal Allowances and One-Year Rule can be found in the Guide to Financial Operations Chapter XIII, Section …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1674-year-end-procedure-taxable-employee-expense-reimbursementsChildren's Development Group, PLLC – Compliance With the Reimbursable Cost Manual
… to the deficiencies we identified. To CDG : Ensure that all costs reported on annual CFRs fully comply with SED …
https://www.osc.ny.gov/state-agencies/audits/2019/12/11/childrens-development-group-pllc-compliance-reimbursable-cost-manualMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… Purpose To determine whether Medicaid made improper fee-for-service … Medicaid provides a wide range of medical services to those who are economically disadvantaged and/or have …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careMedicaid Program – Medicaid Claims Processing Activity October 1, 2017 Through March 31, 2018
… were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit covered the … 2018, eMedNY processed over 184 million claims, resulting in payments to providers of more than $31 billion. The claims …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/medicaid-program-medicaid-claims-processing-activity-october-1-2017-through-march-31-2018State Health Department Unnecessarily Paid over $1 Billion for Patients Covered by Private Insurance
… through New York State of Health (NYSOH), New York's online health insurance marketplace and the remainder were …
https://www.osc.ny.gov/press/releases/2018/06/state-health-department-unnecessarily-paid-over-1-billion-patients-covered-private-insuranceState Agencies Bulletin No. 1031
… to employee business expense reimbursements require withholding and Form W-2 reporting on any excess amounts … deficiency deducted from a 2011 paycheck. To avoid under-withholding of income taxes for 2010 and subsequent …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1031-year-end-procedure-taxable-travel-reimbursementState Agencies Bulletin No. 1093
… travel reimbursements in order for the State to comply with IRS reporting requirements. This bulletin replaces … be run on 12/09/11. This transfer will include vouchers with taxable reimbursements paid by the CAS from 12/01/11 … Medicare tax deficiencies in 2012, agencies should work with their employees to accelerate the submission of travel …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1093-year-end-procedure-taxable-travel-reimbursements