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DiNapoli: State Medicaid Needs to Stop Paying Bills That Federally Funded Plans Should Cover
… health care plan, such as the Essential Plan or Medicare, should have paid. These shortcomings are … plans. Medicaid Paying Costs That Should Be Covered By Medicare Most individuals receiving Medicaid are required to apply for federally-funded Medicare at age 65. Under DOH’s supervision, local …
https://www.osc.ny.gov/press/releases/2023/09/dinapoli-state-medicaid-needs-stop-paying-bills-federally-funded-plans-should-coverState Agencies Bulletin No. 1682
… how OSC will handle current year Social Security and/or Medicare (FICA) tax deficiencies for inactive employees … Employees Employees who incurred a Social Security and/or Medicare tax deficiency and have since left the New York …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1682-current-year-social-security-andor-medicare-tax-deficiencies-and-impactUnited HealthCare – Overpayments for Services Provided by Dr. John Gomes
… 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. The New York State Department of Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-dr-john-gomesUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
To determine whether Orthopedic Associates of Long Island LLP waived Empire Plan members outofpocket costs and if so to quantify the overpayments made by
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandCUNY Bulletin No. CU-531
… Purpose To inform agencies of the new flat rate deduction codes that will be used to recover … Security tax deficiencies for City University of New York (CUNY) employees. Affected Employees CUNY employees with …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-531-new-deduction-codes-580-city-university-new-york-medicareState Agencies Bulletin No. 964
… a decrease in the reported wages and Social Security and Medicare taxes Effective Date(s) Immediately Background Previously, refunds of Social Security and Medicare taxes were remitted to employees as soon as the OSC … will no longer immediately issue the Social Security and Medicare tax refund when the C8EMP form is processed. OSC …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/964-procedure-change-prior-year-ssmed-tax-refundsNYSHIP: Payments by Empire BlueCross for Hospital Services for Ineligible Members (2019-S-32)
To determine whether Empire BlueCross paid hospital claims for members who were not eligible. The audit covered the period January 1, 2014 through December...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s32.pdfOpinion 97-2
… in a municipal cooperative health benefit plan for Part B Medicare premiums paid by the former school board member. … school district's local health insurance plan for Part B Medicare insurance premiums paid by the former school board …
https://www.osc.ny.gov/legal-opinions/opinion-97-2UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers (Follow-Up)
… the Program The New York State Health Insurance Program (NYSHIP) covers over 1.2 million active and retired State, … and school district employees, and their dependents. NYSHIP’s primary health benefit plan is the Empire Plan. …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryState Agencies Bulletin No. 1364
… are receiving a prior year refund of Social Security and Medicare taxes for any reason, including Workers’ … refund on the employee’s portion of Social Security and/or Medicare taxes. This form also certifies that the employee …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1364-new-procedure-reporting-prior-year-social-security-and-medicare-taxMedicaid Program – Medicare Part D Clawback Payments
… whether the Department of Health (Department) overpaid the Medicare Part D prescription drug phased-down state … program. Effective January 1, 2006, pursuant to the Medicare Prescription Drug, Improvement, and Modernization …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/medicaid-program-medicare-part-d-clawback-paymentsMadrid-Waddington Central School District - Claims Audit Process (2019M-1)
… two claims totaling $251,601 for health insurance and Medicare reimbursement. In addition, two claims totaling … approve any of the District’s health insurance claims and Medicare reimbursement payments, which totaled $3.5 million. … Ensure that all claims for health insurance, Medicare reimbursements and scholarship payments are …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1United 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 Laparoscopic Surgery
… The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … it will result in United making an excessive payment on the claim. Our audit focused on claims submitted to United by Long Island Laparoscopic …
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 hospital …
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 Long Island Spine Specialists
… The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … it will result in United making an excessive payment on the claim. Our audit focused on claims submitted to United by Long Island Spine …
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-auditsCUNY 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-healthState Agencies Bulletin No. 1223
… for 2013. The temporary reduction in Social Security payroll tax rate (4.2%) for employees expires December 31, …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1223-summary-tax-related-withholding-requirements-2013Medicaid Program – Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare
… individuals receiving hospice care covered by Medicare. This audit covered the period January 1, 2015 … 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/2020/12/28/medicaid-program-improper-medicaid-payments-individuals-receiving-hospice-services-covered