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Medicaid Program – Improper Managed Care Payments for Recipients With Duplicate Client Identification Numbers
… Districts) and the NY State of Health (NYSOH, the State’s online health plan marketplace). Local Districts use the …
https://www.osc.ny.gov/state-agencies/audits/2019/07/29/medicaid-program-improper-managed-care-payments-recipients-duplicate-client-identificationDiNapoli Announces State Contract And Payment Actions For October 2015
… Pre-Kindergarten program. $77,000 to New Ventures Charter School for planning and implementation. Office of General …
https://www.osc.ny.gov/press/releases/2015/11/dinapoli-announces-state-contract-and-payment-actions-october-2015Medicaid Program – Payments for Death-Related One-Day Inpatient Admissions
… to the reason for admission and severity of illness in calculating reimbursements. Usually, the more severe the …
https://www.osc.ny.gov/state-agencies/audits/2013/08/15/medicaid-program-payments-death-related-one-day-inpatient-admissionsState Comptroller DiNapoli Releases State Audits and Examinations
… announced today the following audits and examinations have been issued: Central New York Regional Transportation … identified several matters that management should address to improve Centro’s information security program for cardholder data and to help ensure it meets PCI requirements. Public Service …
https://www.osc.ny.gov/press/releases/2017/02/state-comptroller-dinapoli-releases-state-audits-and-examinationsNew York State Health Insurance Program – Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan
… not have Medicare. Claims paid under the Medicare Rx Plan are eligible for enhanced drug manufacturer discounts and federal subsidies that are not available for claims paid under the Commercial Plan. … ensuring that claims for Medicare-enrolled individuals are paid under the Medicare Rx Plan allows for a significant …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/new-york-state-health-insurance-program-incorrect-payments-cvs-caremark-medicare-rx-drugState Comptroller DiNapoli Releases Audits
… to ensure they paid employees at the prevailing wage rate, but auditors found some shortcomings. In a follow-up, … $7,958 in ineligible costs that HSOR reported for reimbursement. State Education Department: Developmental … ineligible costs that Leake and Watts reported for state reimbursement. State Education Department: Pinnacle …
https://www.osc.ny.gov/press/releases/2019/01/state-comptroller-dinapoli-releases-auditsMedicaid Program – Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare
… to as dual-eligibles), Medicare is the primary payer for Medicare-covered hospice services, while Medicaid is the payer of last resort. Several entities are responsible for coordinating services on behalf of individuals who are … to delivering services, hospice providers are responsible for developing a comprehensive plan of care and coordinating …
https://www.osc.ny.gov/state-agencies/audits/2020/12/28/medicaid-program-improper-medicaid-payments-individuals-receiving-hospice-services-coveredKidz Therapy Services, PLLC – Compliance With the Reimbursable Cost Manual
… and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost Manual (Manual). The audit covered … education programs to disabled children between the ages of three and five years. During the 2013-14 school year, Kidz … SED reimburses the school districts for a portion of their payments to Kidz Therapy based on statutory rates. For the …
https://www.osc.ny.gov/state-agencies/audits/2016/09/15/kidz-therapy-services-pllc-compliance-reimbursable-cost-manualSmall Wonder Preschool, Inc. – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Small Wonder Preschool, Inc. (Small Wonder) on its … to children with disabilities who are between the ages of 3 and 5 years. For the purpose of this report, this program is referred to as the SED …
https://www.osc.ny.gov/state-agencies/audits/2024/09/05/small-wonder-preschool-inc-compliance-reimbursable-cost-manualState Comptroller DiNapoli Releases State Audits
… Leaves (Follow-Up) (2015-F-5) An initial audit issued in October 2013 examined whether the fellowship leaves … staff were awarded for authorized purposes and in compliance with requirements. Auditors found that although … complied with CUNY policy, improvements were needed. In a follow-up report, auditors found CUNY has made progress …
https://www.osc.ny.gov/press/releases/2016/08/state-comptroller-dinapoli-releases-state-audits-0DiNapoli: Managed Care Companies Wasting Millions in State Medicaid Dollars
… period, including almost $60,000 in payments to pharmacies for medications that were prescribed by deceased doctors, … wasted.” DOH contracts with MCOs to coordinate the care for enrolled Medicaid beneficiaries. In exchange, MCOs … determine if the MCOs’ recoveries have an impact on the monthly managed care premium rate calculations, and …
https://www.osc.ny.gov/press/releases/2016/07/dinapoli-managed-care-companies-wasting-millions-state-medicaid-dollarsState Comptroller DiNapoli Releases Audits
… announced today the following audits and examinations have been issued. Office of Alcoholism and Substance Abuse … was not accurate or complete, and Metro-North does not have a process in place to verify reported data. New York … announced today the following audits and examinations have been issued …
https://www.osc.ny.gov/press/releases/2019/03/state-comptroller-dinapoli-releases-auditsMedicaid Program – Medicaid Payments to Medicare Advantage Plan Providers
… through Medicare Advantage plans, which have networks of participating providers that they reimburse for services … selected Medicare Advantage plan contracts offered by Fidelis and WellCare and, based on judgmental sampling, … on 7,072 Medicaid claims resulting in overpayments of $770,935. We determined three of the providers were …
https://www.osc.ny.gov/state-agencies/audits/2018/09/10/medicaid-program-medicaid-payments-medicare-advantage-plan-providersLeague for the Handicapped – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the League for the Handicapped (LFH) on its Consolidated Fiscal … … To determine whether the costs reported by the League for the Handicapped LFH on its Consolidated Fiscal …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/league-handicapped-compliance-reimbursable-cost-manualXII.6.I Paying a Non-State Employee – XII. Expenditures
… be used “as is” or as a template to create a determination form specific to the Business Unit’s needs. … IRS determine the worker’s classification by filing IRS Form SS-8. Attachment C – IRS Publication 963, Chapter 4, … to process these payments, the AC 3253-S Claim for Payment form must be completed and maintained by the funding Business …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii6i-paying-non-state-employeeEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member …
https://www.osc.ny.gov/state-agencies/audits/2013/05/09/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughCUNY Bulletin No. CU-547
… Deficiency) with an effective date prior to 9/1/16 and will remain at their current rate. Affected Employees … under Deduction Code 582 prior to September 1, 2016, and then becomes obligated to repay additional FICA on or … This adjustment procedure for underpaid FICA taxes benefits employers and employees, by allowing them to correct …
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
… obligation. Any change in employee income tax obligations are solely the employee’s responsibility to address with the … tax and income tax withholding. The adjustment rules are designed to provide a streamlined, interest-free … employer, once OSC becomes aware of a FICA deficiency, we are required to correct the employee wages and remit both the …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1493-new-repayment-rate-deduction-code-502-nys-ssmedicare-deficiencyMedicaid Program: Overpayments for Medicare Part C Claims (2023-S-13)
To determine whether Medicaid made improper payments on Medicare Part C claims for recipients covered by Medicare Advantage Plans.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-23s13.pdfImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… for Individuals Receiving Hospice Services Covered by Medicare (Report 2018-S-71 ). About the Program Hospice is a … drugs. When individuals are enrolled in both Medicaid and Medicare (referred to as dual-eligibles), Medicare is the …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-follow