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Overpayments for Services Also Covered by Medicare Part B (Follow-Up)
… implemented. Key Recommendation Officials are given 30 days after the issuance of the follow-up report to provide …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followMedicaid Program – Overpayments for Medicare Part C Claims
… To determine whether Medicaid made improper payments on Medicare Part C claims for recipients covered by Medicare … from May 2018 through April 2023. About the Program Under Medicare Part C, private insurance companies administer … To determine whether Medicaid made improper payments on Medicare Part C claims for recipients covered by Medicare …
https://www.osc.ny.gov/state-agencies/audits/2024/12/04/medicaid-program-overpayments-medicare-part-c-claimsMedicaid Program – Improper Supplemental Maternity Capitation Payments to Managed Care Organizations
… the Department pays managed care organizations (MCOs) a monthly premium for each enrolled recipient and, in turn, … In addition to the monthly premiums, MCOs can receive a one-time Supplemental Maternity Capitation Payment (SMCP) for the prenatal and postpartum physician care and hospital or …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-supplemental-maternity-capitation-payments-managed-careMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… Medicaid claims for services also covered by Medicare Advantage plans. The audit covered the period from January 1, … Part C, also known as Medicare Managed Care or Medicare Advantage. Under Medicare Part C, private managed care … offer different health care plans (referred to as Medicare Advantage plans) tailored to the specific needs of Medicare …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesMedicaid 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 disabled. It consists of several parts. Medicare Part B helps pay for medical care provided in …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-program-overpayments-services-also-covered-medicare-part-bOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… Purpose To determine the extent of implementation of the two recommendations made in our audit report, … To determine the extent of implementation of the two recommendations made in our audit report …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followCost 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.pdfState Agencies Bulletin No. 1043
… Purpose To inform agencies of the content information for the 2010 Form W-2. Background … An employee who has worked for one (1) company, State of New York (NYS) or City University of New York (CUNY) during the year will receive only one (1) … To inform agencies of the content information for the 2010 Form W2 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1043-form-w-2-wage-and-tax-statement-calendar-year-2010State Agencies Bulletin No. 950
… Purpose To inform agencies of the content information for the 2009 Form W-2 Background According to IRS Publication 15, Circular E for 2009, and the Instructions for Form W-2 (Wage and Tax Statement), employers are required … To inform agencies of the content information for the 2009 Form W2 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/950-form-w-2-wage-and-tax-statement-calendar-year-2009Medicaid Overpayments for Medicare Advantage Plan Services (Follow-Up)
… (Report 2017-S-46 ). About the Program The Department of Health (Department) administers the State’s Medicaid program. … companies administer Medicare benefits and offer different health care plans (referred to as Medicare Advantage plans … to meet the specific needs of Medicare enrollees. When a health care service is covered by a Medicaid recipient’s …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followMedicaid Program – Improper Premium Payments Made on Behalf of Managed Care Members Residing Outside the State
… of Health (DOH) improperly paid Medicaid managed care premiums on behalf of members who resided outside of New … be disenrolled from their plan and the plan must return premiums paid for periods when the member was not a resident. … Medicaid paid almost $1.2 billion in managed care premiums for Medicaid members who may have resided outside of …
https://www.osc.ny.gov/state-agencies/audits/2025/09/09/medicaid-program-improper-premium-payments-made-behalf-managed-care-members-residingMedicaid Program – Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus
… Medicaid mainstream managed care plans and Family Health Plus managed care plans (Plans) for recipients who were no … managed care, during the audit period, Family Health Plus (FHP) was a publicly funded managed care program for … Medicaid mainstream managed care plans and Family Health Plus …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/medicaid-program-inappropriate-premium-payments-recipients-no-longer-enrolled-mainstreamExamination of Outstanding Premiums
… Purpose The objectives of our examination were to determine (i) the extent to which the New York State Insurance Fund (NYSIF) participates in the Statewide Offset Program (SWOP), and (ii) the amount of outstanding premiums NYSIF may have been able to recover …
https://www.osc.ny.gov/state-agencies/audits/2016/08/19/examination-outstanding-premiumsOverpayments 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 “dual-eligibles.” The Medicare program covers physical, occupational, and speech …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followMedicaid Program – Overpayments for Therapy Services and Prescription Drugs Covered by Medicare
… Health overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered by … drugs and January 1, 2012 to December 31, 2017 for therapy services. About the Program Many of the State’s … Medicare program covers physical, occupational, and speech therapy services, as well as prescription drugs. When these …
https://www.osc.ny.gov/state-agencies/audits/2019/10/30/medicaid-program-overpayments-therapy-services-and-prescription-drugs-covered-medicareImproper Medicaid Payments Involving Fee-for-Service Claims for Recipients With Multiple Client Identification Numbers (Follow-Up)
… enrollments of recipients concurrently enrolled in FFS foster care under different CINs; $12.7 million in improper … General (OMIG) recovers improper premium payments for foster care recipients with multiple CINs and, by the end of … not have a process to recover improper payments for non-foster care recipients with concurrent FFS enrollment or …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/improper-medicaid-payments-involving-fee-service-claims-recipients-multiple-clientState Comptroller DiNapoli Releases Audits
… York State Comptroller Thomas P. DiNapoli announced today the following audits have been issued. Office for the Aging (OFA): Long-Term Care Ombudsman Program (Follow - … office data may not have been sufficiently reliable for the agency’s use for analysis at the facility, regional …
https://www.osc.ny.gov/press/releases/2021/01/state-comptroller-dinapoli-releases-auditsComptroller DiNapoli Releases State Audits
… in July 2011, examined the Department of Transportation’s (DOT) oversight of grant activity. Auditors found that the … effective communication and information sharing within the DOT and with other state agencies that also provide grant funding. In a follow-up, auditors found DOT has made progress in correcting the problems identified …
https://www.osc.ny.gov/press/releases/2014/04/comptroller-dinapoli-releases-state-auditsState Comptroller DiNapoli Releases Audits
… and three were not implemented. New York State Health Insurance Program – Anthem Blue Cross – Coordination of Benefits With Medicare (2023-S-3) …
https://www.osc.ny.gov/press/releases/2024/08/state-comptroller-dinapoli-releases-auditsMedicaid Program – Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY
… Medicaid made improper payments to providers who submitted Part B cost-sharing claims directly to eMedNY. The audit … The Medicare program has multiple parts. Medicare Part B provides supplementary medical insurance coverage for … Medicare enrollees are responsible for paying all costs of Part B services until their annual deductible is met. After …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-part-b-services-billed-directly-emedny