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Improper Payments Related to the Medicare Buy-In Program (Follow-Up)
… extent of implementation of the five recommendations made in our audit report, Improper Payments Related to the Medicare Buy-In Program ( 2010-S-76 ). Background The federal government … out-of-pocket Medicare expenses. Under the buy-in program, Medicaid pays the Medicare premiums and sometimes the …
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)
… included in our initial audit report, Overpayments for Therapy Services and Prescription Drugs Covered by … overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered … covered the period January 1, 2012 to December 31, 2016 for prescription drugs and January 1, 2012 to December 31, …
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
… of Health’s (Department) automated claims processing and payment system. When submitting claims, providers are … to determine whether a billed service is eligible for payment as well as the correct payment amount. Key Findings … million and recover overpayments as warranted. Ensure prompt attention is paid to those providers that received the …
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)
… extent of implementation of the two recommendations made in our audit report, Overpayments for Services Also Covered … Many of the State’s Medicaid recipients are also enrolled in Medicare Part B, which provides supplementary medical … fees, and medical supplies. For individuals enrolled in both Medicaid and Medicare, Medicare is generally the …
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)
… made in our initial audit report, Medicaid Payments to Medicare Advantage Plan Providers (Report 2016-S-54 ). About … of the State’s Medicaid recipients are also enrolled in Medicare, the federal health insurance program for people age …
https://www.osc.ny.gov/state-agencies/audits/2019/10/15/medicaid-payments-medicare-advantage-plan-providers-followMedicaid Payments for Medicare Part A Beneficiaries (Follow-Up)
… made in our audit report, Medicaid Payments for Medicare Part A Beneficiaries (2009-S-36). Background Our … made overpayments for recipients who were also enrolled in Medicare Part A. Medicare Part A provides supplementary …
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
… of the State’s Medicaid recipients are also eligible for Medicare, the federal health insurance program for people age … programs are commonly referred to as “dual-eligible.” The Medicare program has multiple parts. Medicare Part B provides supplementary medical insurance …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-part-b-services-billed-directly-emednyUnited HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … process and pay medical claims from health care providers for services provided to Empire Plan members. United …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-laparoscopic-surgeryUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … process and pay medical claims from health care providers for services provided to Empire Plan members. United …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerUnited HealthCare – Overpayments for Services Provided by Hudson Valley Bone and Joint Surgeons, LLP
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital …
https://www.osc.ny.gov/state-agencies/audits/2016/09/08/united-healthcare-overpayments-services-provided-hudson-valley-bone-and-joint-surgeons-llpUnited HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
… and retired State, participating local government, and school district employees and their dependents. The Empire …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-spine-specialistsState Comptroller DiNapoli Releases Audits
… (2023-S-42) The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service … The Empire Plan is the primary health benefits plan for NYSHIP, covering over 1 million members. Since 2014, the …
https://www.osc.ny.gov/press/releases/2025/04/state-comptroller-dinapoli-releases-auditsUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers (Follow-Up)
… included in our initial audit report, Overpayments for Out-of-Network Anesthesia Services Provided at In-Network … the Program The New York State Health Insurance Program (NYSHIP) covers over 1.2 million active and retired State, … on August 13, 2018, examined whether United overpaid for out-of-network anesthesia services provided at ASCs that …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… included in our initial audit report, Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (Report … program. Many Medicaid recipients are also enrolled in Medicare. Under the Medicare buy-in program (Buy-in Program), …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followDiNapoli Finds Over $100 Million in Inappropriate Medicaid Payments
… today released three reports that found more than $100 million in improper payments made by the Department of … drugs and therapy services. It found Medicaid paid $20.1 million for services that should have been paid by … today released three reports that found more than $100 million in improper payments made by the Department of …
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)
… in our initial audit report, Medicaid Overpayments for Medicare Advantage Plan Services (Report 2017-S-46 ). About … program. Many Medicaid recipients are also enrolled in Medicare Part C, commonly referred to as Medicare Managed …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followState Agencies Bulletin No. 468
… for current year Social Security (TF5) or current year Medicare (TF6) refunds. NOTE: THESE NEW EARNINGS CODES ARE … Employees who receive current year Social Security and Medicare tax refunds. Effective Date(s) Checks dated April … ). In order to ensure that employees' Social security and Medicare wages are updated accurately, two additional …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/468-new-earnings-codes-current-year-social-security-and-medicare-adjustmentsCUNY Bulletin No. CU-356
… participate in the New York State Health Insurance Plan (NYSHIP) administered by the New York State Department of …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-356-certain-cuny-employees-eligible-new-york-state-health