Search
Medicaid Program – Excessive Medicaid Payments to Federally Qualified Health Centers for Group Therapy Services
… To determine if Medicaid reimbursement rates for group therapy services provided by Federally Qualified Health … Qualified Health Centers (FQHCs) to provide group therapy services, including group therapy provided by clinical social workers, to Medicaid … To determine if Medicaid reimbursement rates for group therapy services provided by Federally Qualified Health …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/medicaid-program-excessive-medicaid-payments-federally-qualified-health-centers-groupMadrid-Waddington Central School District - Claims Audit Process (2019M-1)
… $251,601 for health insurance and Medicare reimbursement. In addition, two claims totaling $17,848 were improperly paid …
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
… Objective To determine whether Medicaid cost savings can be achieved by modifying the … methodology for Medicare Part C cost-sharing claims in accordance with federal requirements. The audit covered … The Department of Health administers the New York State Medicaid program. Many of the State’s Medicaid recipients are …
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
… whether the Department of Health's eMedNY system processes Medicaid claims for ancillary services in accordance with … and home health care are typical ancillary services. Medicaid claims for ancillary services are processed by … whether the Department of Healths eMedNY system processes Medicaid claims for ancillary services in accordance with …
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
… whether mainstream managed care organizations (MCOs) are submitting accurate administrative costs to the … provides a wide range of medical services to those who are economically disadvantaged and/or have special health … for setting the monthly managed care premium rates, which are based, in part, on allowable MCO administrative costs. …
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 … worth of deductions claimed by an estimated one million New Yorkers. "Without further action, the bill would force … health insurance premiums or loss of coverage for many New Yorkers. "The legislation will drive up the cost 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
… To determine if Medicaid made excessive payments for Medicare Part C cost-sharing liabilities. The audit covered … to as "dual-eligibles." In 1997, Congress established Medicare Part C, also known as Medicare managed care or Medicare Advantage. Under Medicare Part C, private managed care companies administer …
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
… of the state Department of Health’s (DOH) oversight of the Medicaid program. The audits identified approximately $790 … for the coming fiscal year, in part because of higher Medicaid spending,” DiNapoli said. “Over the last four years, my auditors have focused on the Medicaid program, uncovering billions of dollars in waste, …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-medicaid-audits-find-nearly-800-million-savings-and-revenueState Agencies Bulletin No. 1434
… the 2015 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … XIII, Section 4.E . OSC Actions Each month, taxable travel reimbursement data is transferred from the Statewide … respectively. OSC Actions (Year-end) Any taxable travel reimbursement paid by the SFS from December 5, 2015 through …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1434-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1513
… the 2016 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … XIII Section 4.E . OSC Actions Each month, taxable travel reimbursement data is transferred from the Statewide … 2016, respectively. OSC Actions (Year End) Taxable travel reimbursement paid by SFS from December 3, 2016 through …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1513-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1356
… the 2014 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … XIII, Section 4.E . OSC Actions Each month, taxable travel reimbursement data is transferred from Statewide Financial … respectively. OSC Actions (Year-end) Any taxable travel reimbursement paid by the SFS from December 6, 2014 through …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1356-year-end-procedure-taxable-employee-expense-reimbursementsOverpayments of Certain Medicare Crossover Claims
… Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify the claims processing control weaknesses that … individuals, Medicare is the primary claims payer - and Medicaid, as a secondary payer, pays the individual's …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsState Agencies Bulletin No. 1674
… agencies with the 2018 calendar year-end procedures for taxable travel reimbursement Background Taxable travel … by receipts. The 2018 maximum rate allowed by IRS for PCM is 54.5 cents per mile effective from January 1, 2018 … December 31, 2018. Current maximum Federal per diems for the continental U.S. can be found in the Guide to …
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 … by receipts. The 2017 maximum rate allowed by IRS for PCM is 53.5 cents per mile effective from January 1, 2017 … December 31, 2017. Current maximum Federal per diems for the continental U.S. can be found in the Guide to …
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
To determine whether the costs submitted by Childrens Development Group PLLC on its Consolidated Fiscal Report were allowable properly
https://www.osc.ny.gov/state-agencies/audits/2019/12/11/childrens-development-group-pllc-compliance-reimbursable-cost-manualTraining 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 – Medicaid Claims Processing Activity October 1, 2017 Through March 31, 2018
… in excess of permitted limits; and $360,651 was paid for clinic and inpatient claims; $357,020 was paid for drugs … recipients who were improperly enrolled in managed care, saving the Medicaid program an estimated $2.1 million in …
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 … Medicaid made improper feeforservice claim payments for pharmacy services covered by recipients managed care plans …
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
… paid $1.28 billion in unnecessary Medicaid managed care premiums over a nearly six-year period for enrollees who already had private insurance, according to an audit released today by State … managed care retroactively and recover the unnecessary premiums paid to the MCO, according to rules in the Medicaid …
https://www.osc.ny.gov/press/releases/2018/06/state-health-department-unnecessarily-paid-over-1-billion-patients-covered-private-insurance