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Medicaid 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 … properly bill Medicaid for group therapy services. Ensure all FQHCs bill Medicaid the correct reimbursement rate for …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/medicaid-program-excessive-medicaid-payments-federally-qualified-health-centers-groupImproper 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.pdfMadrid-Waddington Central School District - Claims Audit Process (2019M-1)
… Determine whether claims were adequately documented, were for appropriate purposes and were properly audited and … claims auditor did not audit two claims totaling $251,601 for health insurance and Medicare reimbursement. In addition, … $5,700. Key Recommendations Ensure that all claims for health insurance, Medicare reimbursements and scholarship …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1Medicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… 1, 2011 through December 31, 2015. Background The New York State Medicaid program is a federal, state, and locally funded program that provides a wide range … guidance. As of early 2015, the total value of the contract was $38.6 million. Under the New York State Social …
https://www.osc.ny.gov/state-agencies/audits/2016/10/13/medicaid-program-mainstream-managed-care-organizations-administrative-costs-used-premiumMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… of Health's eMedNY system processes Medicaid claims for ancillary services in accordance with Medicaid … categories: diagnostic, therapeutic, and custodial. For example, laboratory, physical therapy, and home health … care are typical ancillary services. Medicaid claims for ancillary services are processed by eMedNY, the …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid 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 … both Medicaid and Medicare. Medicare is the primary payer for medical services provided to these dual-eligible recipients. Medicaid typically pays for cost-sharing liabilities, which include Medicare …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-cost-saving-opportunities-payments-medicare-part-c-claimsNew 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 … $1.1 billion in total long-term savings for the state. Local governments, school districts and public …
https://www.osc.ny.gov/press/releases/2017/12/new-york-state-comptroller-thomas-p-dinapoli-statement-federal-tax-reform-0DiNapoli: Medicaid Audits Find Nearly $800 Million in Savings and Revenue
… billions of dollars in waste, fraud and abuse. Our role is to help lower Medicaid program costs by identifying … earnest as the state Department of Health can do much more to save taxpayer dollars.” The New York State Medicaid … program that provides a wide range of health care services to individuals who are economically disadvantaged or have …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-medicaid-audits-find-nearly-800-million-savings-and-revenueChildren's Development Group, PLLC – Compliance With the Reimbursable Cost Manual
… and adequately documented in accordance with applicable State Education Department (SED) requirements. The audit …
https://www.osc.ny.gov/state-agencies/audits/2019/12/11/childrens-development-group-pllc-compliance-reimbursable-cost-manualMedicaid Program – Medicaid Payments Made Pursuant to Medicare Part C
… Purpose To determine if Medicaid made excessive payments for Medicare … in Medicare. Such recipients are commonly referred to as "dual-eligibles." In 1997, Congress established …
https://www.osc.ny.gov/state-agencies/audits/2014/05/09/medicaid-program-medicaid-payments-made-pursuant-medicare-part-cMedicaid Program – Medicaid Claims Processing Activity October 1, 2017 Through March 31, 2018
… Purpose To determine whether the Department of Health’s eMedNY system … Medicaid requirements, and resulted in correct payments to the providers. The audit covered the period October 1, …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/medicaid-program-medicaid-claims-processing-activity-october-1-2017-through-march-31-2018Training Resources for State Agencies and Employees
View training materials and ondemand videos for classes presented by the Office of Operations
https://www.osc.ny.gov/state-agencies/trainingMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… made improper fee-for-service claim payments for pharmacy services covered by recipients’ managed care plans. The audit … 31, 2013. Background Medicaid provides a wide range of medical services to those who are economically disadvantaged and/or have special health care needs. In general, the Medicaid program pays …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careState Agencies Bulletin No. 1513
To provide agencies with the 2016 calendar yearend procedures for taxable travel reimbursement
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1513-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1434
To provide agencies with the 2015 calendar yearend procedures for taxable travel reimbursement
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1434-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1356
… by IRS for PCM is 56 cents per mile effective from January 1, 2014 through December 31, 2014. Current maximum … amounts to the employee’s reportable taxable income in box 1 on the employee’s 2014 Form W-2. Social Security/Medicare … 5, 2014. Questions Questions regarding this bulletin may be e-mailed to the Tax and Compliance mailbox. Please …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1356-year-end-procedure-taxable-employee-expense-reimbursementsDiNapoli: Audit Finds $6.8 Million in Medicaid Overpayments
… New York state’s Medicaid system made approximately $6.8 million in … care plans, according to an audit released today by State Comptroller Thomas P. DiNapoli. By the end of audit …
https://www.osc.ny.gov/press/releases/2016/11/dinapoli-audit-finds-68-million-medicaid-overpaymentsState Agencies Bulletin No. 1674
… and are subject to employment and income taxes. Federal, State and New York City income tax withholding will be …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1674-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1596
… and are subject to employment and income taxes. Federal, State and New York City income tax withholding will be …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1596-year-end-procedure-taxable-employee-expense-reimbursementsOverpayments of Certain Medicare Crossover Claims
… Purpose To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify the claims processing control weaknesses that …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claims