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Madrid-Waddington Central School District - Claims Audit Process (2019M-1)
… purposes and were properly audited and approved prior to payment. Key Findings We reviewed 100 claims totaling … to the claims auditor for audit and approval prior to payment. Ensure no claims, other than those allowed by Law, … purposes and were properly audited and approved prior to payment …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1Improper 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 – Cost Saving Opportunities on Payments of Medicare Part C Claims
… by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with federal … deductibles, coinsurance, and copayments. Under Medicare Part C, private companies administer Medicare benefits by … York State Legislature approved a plan for Medicaid to pay 85 percent of dual-eligibles’ copayment or coinsurance on …
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
… the home, medical offices, clinics, and other freestanding sites. They can be classified into three general categories: …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… 2015. Background The New York State Medicaid program is a federal, state, and locally funded program that provides a … MCOs received $17.8 billion in mainstream managed care premiums for nearly 5.2 million Medicaid enrollees. The … Social Services Law, the Department is required to assess certain costs of such actuarial services against all MCOs. …
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 nullify billions of …
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
… Purpose To determine if Medicaid made excessive payments for Medicare Part C cost-sharing liabilities. The audit covered … enrolled in Part C. Key Recommendations Re-evaluate the reimbursement methodology for Medicare Part C cost-sharing, …
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
… program. The audits identified approximately $790 million in savings from eliminating unnecessary payments and … budget gap of $6 billion for the coming fiscal year, in part because of higher Medicaid spending,” DiNapoli said. … had approximately 7.3 million recipients and Medicaid claim costs totaled about $67.4 billion. Improper …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-medicaid-audits-find-nearly-800-million-savings-and-revenueState Agencies Bulletin No. 1434
… Excess Personal Car Mileage (PCM) Reimbursements Excess Per Diem Payments Non-Overnight Meal Allowances Employee Payments … Taxable Under the IRS One-Year Rule Excess PCM and Per Diem Amounts: IRS rules relating to employee business …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1434-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1513
… Excess Personal Car Mileage (PCM) Reimbursements Excess Per Diem Payments Non-Overnight Meal Allowances Employee Payments … Taxable Under the IRS One-Year Rule Excess PCM and Per Diem Amounts: IRS rules relating to employee business …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1513-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1356
… for Social Security and Medicare tax deficiencies in 2015, Payroll Officers should work with their employees 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
… Purpose To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify … adjustment codes; and did not properly apply Medicaid reimbursement limits. The potential overpayments totaled …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsState Agencies Bulletin No. 1674
… Institution paychecks dated December 12, 2018 and December 20, 2018, respectively. OSC Actions (Year End) Any taxable …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1674-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1596
… agencies with the 2017 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … in box 1 on the employee’s 2017 Form W-2. Social Security/Medicare tax deficiency deductions will be initiated in early …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1596-year-end-procedure-taxable-employee-expense-reimbursementsChildren's Development Group, PLLC – Compliance With the Reimbursable Cost Manual
… The audit covered costs reported on CDG’s CFR for the reporting year ended June 30, 2016. About the Program … CDG reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with SED’s … in other than personal service costs – such as insurance premiums and property lease payments – that did not meet one …
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
… provide medical services. As of August 2017, 4.4 million people were enrolled in mainstream managed care plans – about … coverage. DOH's policy is to exclude Medicaid recipients from mainstream managed care when they have concurrent … and the third-party provider are the same, the state can remove the recipients from managed care retroactively and …
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
… Excess Per Diem Payments; Non-Overnight Meal Allowances; and Employee Payments Taxable Under the IRS … found under the NYS Travel Guidelines . Non-Overnight Meal Allowances IRS requires employers to report and withhold … Security and Medicare tax deficiencies in 2011, agencies should work with their employees to accelerate the submission …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1031-year-end-procedure-taxable-travel-reimbursementState Agencies Bulletin No. 1093
… Reimbursements Excess Per Diem Payments Non-Overnight Meal Allowances Employee Payments Taxable Under the IRS One-Year … found under the NYS Travel Guidelines . Non-Overnight Meal Allowances IRS requires employers to report and withhold … Security and Medicare tax deficiencies in 2012, agencies should work with their employees to accelerate the submission …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1093-year-end-procedure-taxable-travel-reimbursements