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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
… can be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with … covered the period from July 1, 2016 through December 31, 2020. About the Program The Department of Health administers … both Medicaid and Medicare. Medicare is the primary payer for medical services provided to these dual-eligible …
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
… Medicaid claims detected by eMedNY are either denied or paid and reported to Department officials for review. … also covered by Medicare. Enhance existing eMedNY edits or implement new edits to detect any improper claim for … edit enhancements should also provide for the prevention or recovery of related payments. Other Related Audits/Reports …
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
… Purpose To determine whether mainstream managed care organizations … disadvantaged and/or have special health care needs. For the State fiscal year ended March 31, 2015, New York’s … The Department issues MMCOR instructions to guide MCOs on how to report administrative expenses. Of the $17.8 billion …
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
… in Congress remains a bad deal for New York. "The cap on state and local tax deductions would nullify billions of … "The legislation will drive up the cost of borrowing for state and local governments' capital investments by …
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
… state's 160,000 contracts, billions in state payments and public authority data. Visit the Reading Room for contract …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-medicaid-audits-find-nearly-800-million-savings-and-revenueState Agencies Bulletin No. 1513
… Purpose To provide agencies with the 2016 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/1513-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1434
… Purpose To provide agencies with the 2015 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/1434-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1356
… 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 … 2014 through December 31, 2014 will be handled differently in PayServ. Taxable travel reimbursements are subject to …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1356-year-end-procedure-taxable-employee-expense-reimbursementsOverpayments of Certain Medicare Crossover Claims
… under 65 with certain disabilities. Individuals enrolled in both programs are commonly referred to as "dual eligible." In general, for dual eligible individuals, Medicare is the … Medicare crossover claims. Review the $16.4 million in potential Medicaid overpayments and recover where …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsState Agencies Bulletin No. 1596
… the 2017 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … business expense reimbursements require withholding and Form W-2 reporting on any excess amounts paid. “Excess … XIII, Section 4.E . OSC Actions Each month, taxable travel reimbursement data is transferred from the Statewide …
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
… reported on CDG’s CFR for the reporting year ended June 30, 2016. About the Program CDG is an SED-approved, … (RCM) requirements. For the reporting year ended June 30, 2016, CDG reported $427,599 in reimbursable costs for its … counties Key Findings For the reporting year ended June 30, 2016, we identified $166,676 in reported costs that did …
https://www.osc.ny.gov/state-agencies/audits/2019/12/11/childrens-development-group-pllc-compliance-reimbursable-cost-manualMedicaid Program – Medicaid Claims Processing Activity October 1, 2017 Through March 31, 2018
… system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for their claims. During the six-month period ended March 31, … third-party health insurance (TPHI); $3.2 million was paid for claims that were billed with incorrect information …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/medicaid-program-medicaid-claims-processing-activity-october-1-2017-through-march-31-2018Medicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… Purpose To determine whether Medicaid made improper fee-for-service claim payments for pharmacy services covered by recipients’ managed care … program pays medical providers through either the fee-for-service method or the managed care plan method. Under the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careState Health Department Unnecessarily Paid over $1 Billion for Patients Covered by Private Insurance
… premiums were paid to MCOs that were related through some form of ownership (such as parent, subsidiary, or affiliate) …
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
… 2010 FormW-2s. Other corrections that agencies choose to make to the PCM file must be made by 1/07/11 to be reflected …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1031-year-end-procedure-taxable-travel-reimbursementState Agencies Bulletin No. 1093
… Purpose To update calendar year-end procedures relating to taxable travel reimbursements in order for the State to … is taxable. Jane's pay stub for 12/21/11 shows year-to-date gross wages of $63,000. The 12/30/11 VOU943 will show an …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1093-year-end-procedure-taxable-travel-reimbursements