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Overpayments of Certain Medicare Crossover Claims (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations made in our audit report, Overpayments of Certain Medicare Crossover Claims (2011-S-28). Background … To determine the extent of implementation of the five recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followNew York State Health Insurance Program – Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan
… March 2022. About the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of … for the Empire Plan. This program includes the Empire Plan Medicare Rx drug plan (Medicare Rx Plan) for retired members and their dependents …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/new-york-state-health-insurance-program-incorrect-payments-cvs-caremark-medicare-rx-drugImproper Payments Related to the Medicare Buy-In Program (Follow-Up)
… report, Improper Payments Related to the Medicare Buy-In Program ( 2010-S-76 ). Background The federal government established the Medicare buy-in program to assist certain low-income people pay out-of-pocket Medicare expenses. Under the buy-in program, Medicaid pays the Medicare premiums and sometimes …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… Objective To assess the extent of implementation of the three recommendations included in our initial audit … The New York State Medicaid program provides a wide range of medical services to those who are economically … To assess the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followOverpayments for Medicare Part C Coinsurance Charges (Follow-Up)
… Purpose To determine the extent of implementation of the one recommendation included in our initial audit … Medicare benefits. Medicare Advantage Plans have networks of participating providers that the plans reimburse directly … To determine the extent of implementation of the one recommendation included in our …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/overpayments-medicare-part-c-coinsurance-charges-followUnnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)
… included in our initial audit report, Unnecessary Managed Care Payments for Medicaid Recipients With Medicare (Report … (Department) made premium payments to Medicaid managed care plans for Medicaid recipients who also had Medicare … we identified about 271,000 unnecessary Medicaid managed care payments (totaling about $111 million) that were made on …
https://www.osc.ny.gov/state-agencies/audits/2013/11/01/unnecessary-managed-care-payments-medicaid-recipients-medicare-followMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… Purpose To determine if the Department of Health overpaid health care providers’ Medicaid claims for … Medicare Advantage plans) tailored to the specific needs of Medicare beneficiaries. Some Medicare Advantage plans … the reasons why to providers on the Explanation of Benefits (EOB) using Claim Adjustment Reason Codes …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… for Services Also Covered by Medicare Part B (Report 2012-S-27). Background Many of the State’s Medicaid … for Services Also Covered by Medicare Part B (2012-S-27) Department of Health: Overpayments for Services …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followMedicaid Payments to Medicare Advantage Plan Providers (Follow-Up)
… Objective To determine the extent of implementation of the three … made in our initial audit report, Medicaid Payments to Medicare Advantage Plan Providers (Report 2016-S-54 ). … To determine the extent of implementation of the three …
https://www.osc.ny.gov/state-agencies/audits/2019/10/15/medicaid-payments-medicare-advantage-plan-providers-followIncorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)
… Objective To assess the extent of implementation of the three recommendations included in our initial audit … Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), is one of the nation’s … To assess the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-underMedicaid Payments for Medicare Part A Beneficiaries (Follow-Up)
… Purpose To determine the extent of implementation of the four recommendations made in our audit report, … Medicare is the primary payer and generally covers most of the eligible costs for health services. Medicaid, as a … To determine the extent of implementation of the four recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2014/04/04/medicaid-payments-medicare-part-beneficiaries-followMedicaid Program – Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY
… from June 1, 2012 through May 31, 2017. Background Many of the State’s Medicaid recipients are also eligible for … supplementary medical insurance coverage for a range of outpatient medical services, physician services, and … Medicare enrollees are responsible for paying all costs of Part B services until their annual deductible is met. …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-part-b-services-billed-directly-emednyReimbursement of Social Services Costs (2013MS-3)
… errors (under-billings and over-billings) or a failure to bill at all. We identified additional opportunities for … to the DSS in an effort to accurately capture and bill direct expenditures related to social services. Maintain …
https://www.osc.ny.gov/local-government/audits/county/2013/12/13/reimbursement-social-services-costs-2013ms-3Forms for State Agencies and Employees
… Accounting AC 22‑S Journal Voucher Excel AC 909‑S Report of Moneys Received Excel AC 1286‑S Refund of Appropriation Excel AC 3286‑A Federal Grant Amendment … ) Fillable PDF AC 3173 Agency Report of Taxable Value of Personal Use of an Employer-Provided Vehicle …
https://www.osc.ny.gov/state-agencies/formsImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… in improper Medicare premium payments for individuals who did not have a benefit eligibility period established in … by our audit who had active Buy-in Program coverage but did not have a benefit eligibility period in eMedNY. Of the …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followCVS Health – Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil Service
… by Empire Plan Medicare Rx and found that CVS Health did not always invoice drug manufacturers for rebates, …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/cvs-health-accuracy-empire-plan-medicare-rx-drug-rebate-revenue-remitted-department-civilDiNapoli Finds Over $100 Million in Inappropriate Medicaid Payments
… $100 million in improper payments made by the Department of Health (DOH) for the Medicare buy-in program, maternity … program provides critical health care services to millions of New Yorkers but the program is dogged by oversight … DiNapoli said. “Over the years, we’ve uncovered billions of dollars of waste and abuse in the system. DOH should act …
https://www.osc.ny.gov/press/releases/2021/11/dinapoli-finds-over-100-million-inappropriate-medicaid-paymentsMedicaid Overpayments for Medicare Advantage Plan Services (Follow-Up)
… for Medicare Advantage Plan Services (Report 2017-S-46 ). About the Program The Department of Health … Medicare Part C, commonly referred to as Medicare Managed Care or Medicare Advantage. Under Part C, managed care … specific needs of Medicare enrollees. When a health care service is covered by a Medicaid recipient’s Plan, Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followState Agencies Bulletin No. 468
… Purpose To notify Agencies of two new Earnings Codes, TF8 - SS Refund Wage Adjustment … To notify Agencies of two new Earnings Codes TF8 SS Refund Wage Adjustment and …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/468-new-earnings-codes-current-year-social-security-and-medicare-adjustmentsCorporate Claim Error or Reimbursement Application
In consideration of the payment of this claim, I/we will reimburse to the Office of the State Comptroller and the State of New York the amount due to any additi
https://www.osc.ny.gov/files/unclaimed-funds/claimants/pdf/corporate-claim-error-reimbursement-application.pdf