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Cost Saving Opportunities on Payments of Medicare Part C Claims (2020-S-65) 180-Day Response
To determine whether Medicaid cost savings can be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with federal requirements.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-20s65-response.pdfXII.6.I Paying a Non-State Employee – XII. Expenditures
… Reimbursement . Expenses may include transportation, food, and lodging. Process and Document Preparation: In order …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii6i-paying-non-state-employeeCUNY Bulletin No. CU-547
… repayment plans, using Deduction Code 582 CUNY (SS/Medicare Deficiency), will have a deduction rate of ten … plans currently using Deduction Code 582 CUNY (SS/Medicare Deficiency) with an effective date prior to 9/1/16 … obligation will be converted to Deduction Codes 580 CUNY (Medicare Deficiency) Flat Rate and 581 CUNY (Social Security …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-547-new-repayment-rate-deduction-code-582-cuny-ssmedicareState Agencies Bulletin No. 1493
… may have simultaneous FICA repayment obligations resulting in a total FICA repayment that exceeds ten percent of gross … and 501 NYS/SCF (Social Security Deficiency) Flat Rate in order to maintain the deduction rate of three percent of … also have an increased income tax obligation. Any change in employee income tax obligations are solely the employee’s …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1493-new-repayment-rate-deduction-code-502-nys-ssmedicare-deficiencyIV.4.C General State Charges – IV. Accounting Codes - Uses and Descriptions
… Plans Payments to the M/C Income Protection Plans. 60068 Group Life Insurance Payments to the NYS public employee’s group life insurance plan. 60071 MTA Mobility Tax (Employer … vision care plan. 60100 Workers’ Comp Insurance Premium Group disability insurance program for employees. 60101 …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv4c-general-state-chargesNew York’s Economy and Finances in the COVID-19 Era (June 24, 2021)
… a small share of overall utilization. The U.S. Centers for Medicare & Medicaid Services (CMS) defines telehealth … January 2018 through January 2020 Source: U.S. Centers for Medicare & Medicaid Services Starting in March 2020, … Source: U.S. Centers for Medicare & Medicaid Services Demographic data show that …
https://www.osc.ny.gov/reports/new-yorks-economy-and-finances-covid-19-era-june-24-2021Comptroller DiNapoli Releases State Audits
Auditors found the Research Foundations current methodology for charging SUNY campuses for the costs of central office operations and statewide initiatives the campuses is fair and equitable
https://www.osc.ny.gov/press/releases/2014/01/comptroller-dinapoli-releases-state-auditsMedicaid – Federal Funding and New York
… OSC analysis FIGURE 2 – Medicaid Revenue by Department FY 2026 Preliminary Budget (in millions) Department FY 2025 FY … and statutorily-mandated in New York State Elder Law, NY Connects provides access to information and assistance for … of these reductions have been delayed since 2014 and are now scheduled to begin on October 1, 2025, pending no further …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/medicaid-nycMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… were provided. Had the Department informed the recipients about their entitlement to Medicare and taken proactive steps … in Medicare, the Medicaid program would have saved about $1.5 million over a four-year period. Based on our … or parent. Medicaid payments for these recipients totaled about $553 million for services that Medicare would have …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-diseaseState Comptroller DiNapoli Releases Audits
… A prior audit report, issued in December 2020, identified about $50 million in actual and potential Medicaid … awarded $6.13 million in RESTORE funds, which benefited about 785 senior citizen housing repair projects. A July 2021 …
https://www.osc.ny.gov/press/releases/2023/02/state-comptroller-dinapoli-releases-auditsMedicaid Program – Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare
To determine whether the Department of Health Department took sufficient steps to control the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-reducing-medicaid-costs-recipients-who-are-eligible-medicareReducing Medicaid Costs for Recipients Who Are Eligible for Medicare (Follow-Up)
… The State was required to restart this process and issue Medicaid redetermination notices for Medicaid renewals … effective July 2023 and complete the renewals by December 2025. The objective of our initial audit, issued on September 14, 2023, was to determine whether DOH took …
https://www.osc.ny.gov/state-agencies/audits/2025/08/13/reducing-medicaid-costs-recipients-who-are-eligible-medicare-followDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… 7.4 million enrollees and Medicaid claim costs totaled about $56 billion. The federal government funded about 53.2 percent of New York's Medicaid claim costs; the state funded about 30.6 percent; and localities funded the rest. As noted …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-state-missing-out-millions-medicare-payments-kidney-patientsAudit of the Tuition Reimbursement Account for the Five Fiscal Years Ended March 31, 2018
… are enrolled in a post-secondary private school licensed by the State Education Department (Department), or in a … are also eligible to have their student loans repaid by the Department. Chapter 887 of the Laws of 1990 created …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/audit-tuition-reimbursement-account-five-fiscal-years-ended-march-31-2018Medicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… providers for services rendered to recipients enrolled in UnitedHealthcare’s Medicare Advantage plan: … Background Many Medicaid recipients are also enrolled in Medicare. Such recipients are commonly referred to as “dual-eligibles.” In 1997, Congress established Medicare Part C, the Medicare …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsMedicaid Program – Medicaid Payments to Medicare Advantage Plan Providers
… selected Medicare Advantage plan contracts offered by Fidelis and WellCare and, based on judgmental sampling, … analyzed the remaining Part C cost-sharing claims billed by these providers during the audit period and found – if the …
https://www.osc.ny.gov/state-agencies/audits/2018/09/10/medicaid-program-medicaid-payments-medicare-advantage-plan-providersMedicaid Overpayments for Certain Medicare Part C Claims (Follow-Up)
… of implementation of the three recommendations included in our initial audit report, Medicaid Overpayments for … Many of the State’s Medicaid recipients are also enrolled in Medicare, the federal health insurance program for the … 2015. The audit objective was to identify Medicaid Part C claim overpayments made to medical providers for services …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/medicaid-overpayments-certain-medicare-part-c-claims-followReducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
To determine the implementation status of the five recommendations made in our initial audit report Reducing Medicaid Costs for Recipients With End Stage Renal Disease Report 2015S14
https://www.osc.ny.gov/state-agencies/audits/2018/09/05/reducing-medicaid-costs-recipients-end-stage-renal-disease-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… audit report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of the State's Medicaid recipients are also eligible for Medicare Part B, which provides supplementary medical …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followMedicaid Program – Improper Payments to a Physical Therapist
To determine whether Mark Amir a physical therapist participating in New Yorks Medicaid program billed Medicaid in accordance with its policies and guideline
https://www.osc.ny.gov/state-agencies/audits/2014/12/15/medicaid-program-improper-payments-physical-therapist