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Medicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… rendered to recipients enrolled in UnitedHealthcare’s Medicare Advantage plan: UnitedHealthcare Dual Complete. The … Background Many Medicaid recipients are also enrolled in Medicare. Such recipients are commonly referred to as …
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
… whether Medicaid inappropriately paid for recipients’ Medicare Part C cost-sharing liabilities. The audit covered … Background Many Medicaid recipients are also enrolled in Medicare. Such recipients are commonly referred to as …
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)
… initial audit report, Medicaid Overpayments for Certain Medicare Part C Claims (Report 2013-S-35). Background … of the State’s Medicaid recipients are also enrolled in Medicare, the federal health insurance program for the …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/medicaid-overpayments-certain-medicare-part-c-claims-followMedicaid Program – Cost Saving Opportunities on Payments of Medicare Part C Claims
… be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with … Medicaid recipients are enrolled in both Medicaid and Medicare. Medicare is the primary payer for medical services …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-cost-saving-opportunities-payments-medicare-part-c-claimsReducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
… disease (ESRD) who were eligible for, but not enrolled in Medicare. Medicaid recipients with ESRD may be eligible for Medicare coverage if they meet certain conditions. When Medicaid recipients are enrolled in Medicare, Medicare becomes the primary insurer (payer) and …
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-followCost Saving Opportunities on Payments of Medicare Part C Claims (Follow-Up)
… audit report, Cost Saving Opportunities on Payments of Medicare Part C Claims (Report 2020-S-65 ). About the Program … of the State’s Medicaid recipients are also enrolled in Medicare and are referred to as “dual-eligibles.” Medicare …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/cost-saving-opportunities-payments-medicare-part-c-claims-followState Agencies Bulletin No. 2232
… enters into a new dental services contract for eligible NYSHIP enrollees. These monies will not be added to base … 433 Total Unemployment Ins Owed 442 Pre-Tax Adoption 500 Medicare Deficiency 501 Social Security Deficiency 502 NYS SS/Medicare Deficiency GARNSH Garnishments HIBTRG Regular Before …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2232-public-employees-federation-pef-2024-dental-stipendMedicaid Program – Improper Payments to a Physical Therapist
… “dual-eligible” beneficiaries who are enrolled in both Medicare and Medicaid. Under this arrangement, Medicare is the primary payer and Medicaid pays beneficiaries’ Medicare deductibles and coinsurance. Medicaid claims for …
https://www.osc.ny.gov/state-agencies/audits/2014/12/15/medicaid-program-improper-payments-physical-therapistState Comptroller DiNapoli Releases Audits
… the contract. New York State Health Insurance Program (NYSHIP): CVS Health – Accuracy of Drug Rebate Revenue … of the Empire Plan, the primary health benefits plan for NYSHIP; therefore, Civil Service did not receive $453,029 in …
https://www.osc.ny.gov/press/releases/2021/11/state-comptroller-dinapoli-releases-audits-0Medicaid Program – Overpayments for Services Also Covered by Medicare Part B
… overpaid health care providers for Medicaid claims for Medicare Part B coinsurance. The audit covers the period … January 1, 2009 through December 31, 2009. Background Medicare is a federal health program for the elderly and …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-program-overpayments-services-also-covered-medicare-part-bMedicaid Program – Overpayments for Therapy Services and Prescription Drugs Covered by Medicare
… services and prescription drugs that are covered by Medicare. The audit covered the period January 1, 2012 to … of the State’s Medicaid recipients are also enrolled in Medicare. Such individuals are referred to as …
https://www.osc.ny.gov/state-agencies/audits/2019/10/30/medicaid-program-overpayments-therapy-services-and-prescription-drugs-covered-medicareOverpayments of Certain Medicare Crossover Claims (Follow-Up)
… made in our audit report, Overpayments of Certain Medicare Crossover Claims (2011-S-28). Background Many Medicaid recipients are also enrolled in Medicare, the federal health care program for people 65 years …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followOverpayments of Certain Medicare Crossover Claims
… Purpose To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient … Background Many Medicaid recipients are also eligible for Medicare, the federal health insurance program available to …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsImproper Payments Related to the Medicare Buy-In Program (Follow-Up)
… made in our audit 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 …
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)
… for Therapy Services and Prescription Drugs Covered by Medicare (Report 2016-S-73 ). About the Program The New York … of the State’s Medicaid recipients are also enrolled in Medicare. Such individuals are referred to as …
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)
… included in our initial audit report, Overpayments for Medicare Part C Coinsurance Charges (2011-S-33). Background … rendered to Medicaid recipients enrolled in a Healthfirst Medicare Advantage Plan. Many Medicaid recipients are also …
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)
… Managed Care Payments for Medicaid Recipients With Medicare (Report 2010-S-75). Background Our initial audit … managed care plans for Medicaid recipients who also had Medicare health insurance coverage, known as "dual … about $111 million) that were made on behalf of 45,000 Medicare recipients who were ineligible for Medicaid managed …
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
… providers’ Medicaid claims for services also covered by Medicare Advantage plans. The audit covered the period from … Background Many Medicaid recipients are also enrolled in Medicare Part C, also known as Medicare Managed Care or …
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)
… audit report, Overpayments for Services Also Covered by Medicare Part B (Report 2012-S-27). Background Many of the State’s Medicaid recipients are also enrolled in Medicare Part B, which provides supplementary medical …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-follow