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Medicaid Program – Improper Managed Care Payments for Recipients With Duplicate Client Identification Numbers
… To determine whether improper Medicaid managed care premiums were paid on behalf of recipients with duplicate … pays managed care organizations (MCOs) a monthly premium for each enrolled recipient and, in turn, the MCOs pay for services their members require. Each individual who …
https://www.osc.ny.gov/state-agencies/audits/2019/07/29/medicaid-program-improper-managed-care-payments-recipients-duplicate-client-identificationNew York State Health Insurance Program – Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan
… so claims are paid under the correct plan (Medicare Rx or Commercial). CVS Caremark also relies on information from …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/new-york-state-health-insurance-program-incorrect-payments-cvs-caremark-medicare-rx-drugMedicaid 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
… address to improve Centro’s information security program for cardholder data and to help ensure it meets PCI … officials incorrectly certified some students as eligible for state financial aid awards. Incorrect certifications … practices when calculating $245.9 million in combined premiums and providing $125.3 million in combined discounts …
https://www.osc.ny.gov/press/releases/2017/02/state-comptroller-dinapoli-releases-state-audits-and-examinationsState Comptroller DiNapoli Releases Audits
… Authority of the State of New York (DASNY): Monitoring of Prevailing Wage Compliance on Construction Contracts (Follow-Up) … on its projects to ensure they paid employees at the prevailing wage rate, but auditors found some shortcomings. …
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
… Objective To determine whether Medicaid made improper payments to providers on behalf of dual-eligible individuals receiving … equipment and supplies (totaling $4.1 million) that may have been eligible to be covered by the Medicare hospice …
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
… documented, program-related, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost Manual … in ineligible compensation. Kidz Therapy overstated the number of hours eligible for allocation to the SEIT program; … requirements. Other Related Audits/Reports of Interest State Education Department: Starting Point Services for …
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
… primarily on expenses claimed on Small Wonder’s CFR for the fiscal year ended June 30, 2021 and certain expenses … direct care costs; $1,281 in personal vehicle insurance premiums; $824 in costs that were claimed in the incorrect … on Small Wonder’s CFRs and to Small Wonder’s tuition reimbursement rates, as warranted. Remind Small Wonder …
https://www.osc.ny.gov/state-agencies/audits/2024/09/05/small-wonder-preschool-inc-compliance-reimbursable-cost-manualState Comptroller DiNapoli Releases Audits
… whether OASAS has sufficient treatment programs available for those in need. Department of Health: Medicaid Claims … including $107.7 million in Medicaid managed care premiums were paid on behalf of recipients with concurrent … $263,196 in ineligible costs that ABC reported for reimbursement and recommend such costs be disallowed. These …
https://www.osc.ny.gov/press/releases/2019/03/state-comptroller-dinapoli-releases-auditsState Comptroller DiNapoli Releases State Audits
… leaves granted to CUNY instructional staff were awarded for authorized purposes and in compliance with requirements. … but CUNY did not have the required notification forms for one. Auditors identified two accounts that were not on … State Insurance Fund (NYSIF): Examination of Outstanding Premiums (2016-SIF-01) New York state businesses pay NYSIF …
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 … costs totaled more than $51 billion, of which managed care premiums comprised nearly $27 billion. At the time of …
https://www.osc.ny.gov/press/releases/2016/07/dinapoli-managed-care-companies-wasting-millions-state-medicaid-dollarsMedicaid Program – Medicaid Payments to Medicare Advantage Plan Providers
… Purpose To determine whether Medicaid inappropriately paid for recipients’ Medicare Part C cost-sharing liabilities. The audit covered …
https://www.osc.ny.gov/state-agencies/audits/2018/09/10/medicaid-program-medicaid-payments-medicare-advantage-plan-providersXII.6.I Paying a Non-State Employee – XII. Expenditures
… worker in that: For income tax purposes, the worker may be required to report payments received for his or her services … tax liabilities. The worker will not receive pension plan benefits. The worker will not receive other … may be allowed if the candidate resides over 50 miles from the place of interview in accordance with the rules …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii6i-paying-non-state-employeeLeague for the Handicapped – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by the League for the Handicapped (LFH) on its Consolidated Fiscal Report … LFH’s special education services pay tuition to LFH using reimbursement rates set by SED. SED sets the reimbursement rates based on financial information, including …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/league-handicapped-compliance-reimbursable-cost-manualEmpire 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
… CUNY (SS/Medicare Deficiency), will have a deduction rate of ten percent of gross pay applied. Existing FICA tax … Code 582 CUNY (SS/Medicare Deficiency) with an effective date prior to 9/1/16 and will remain at their current rate. … Administration>Job Information>Job Data>Payroll . When FICA repayment is required by an employee agencies must …
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
… NYS (SS/Medicare Deficiency) will have a deduction rate of ten percent of gross pay applied. Existing FICA tax … Code 502 NYS (SS/Medicare Deficiency) with an effective date prior to 9/1/16 and will remain at their current rate. … Administration>Job Information>Job Data>Payroll . When FICA repayment is required by an employee agencies must …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1493-new-repayment-rate-deduction-code-502-nys-ssmedicare-deficiencyImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… in our initial audit report, Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Report 2018-S-71 ). About the Program Hospice is a …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followMedicaid 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.pdfLong Island Association for AIDS Care
… Department’s AIDS Institute. This report summarizes the results of ourexamination of LIAAC’s claims for payment … for employee medical and dental expenses for the period February 2014 through May 2015. This report also identifies … for medical and dental expenses contained overbillings of $15,777. The claims were returned to the Department. We also …
https://www.osc.ny.gov/state-agencies/audits/2017/11/10/long-island-association-aids-care