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Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… our initial audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). … that exceeded the bed reserve day limit. However, because reimbursement rates were the same for both standard and … reserve days. With the changes to the statutes governing reimbursement for bed reserve days in June 2012, the …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followXIII.11 Submitting Travel and Expense Reimbursement Requests for Inactive Employees – XIII. Employee Expense Reimbursement
… an employee has separated from the agency, the employee’s profile in SFS will have the status “inactive.” A proxy … Employee Data Administrator (EDA) must edit the employee’s profile within SFS by navigating to: SFS Financials>Travel & Expenses>Manage Employee Information>Update Profile Then, the EDA should use the Search By function to …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xiii/xiii11-submitting-travel-and-expense-reimbursement-requests-inactive-employeesMedicaid Program - Medicaid Managed Care Organization Fraud and Abuse Detection
… managed care organizations (MCOs) to coordinate the care for enrolled Medicaid beneficiaries. In exchange, MCOs receive a monthly premium payment for each enrollee. In 2014, New York State’s Medicaid claim … costs totaled more than $51 billion, of which managed care premiums comprised nearly $27 billion. Based on December 2014 …
https://www.osc.ny.gov/state-agencies/audits/2016/07/15/medicaid-program-medicaid-managed-care-organization-fraud-and-abuse-detectionMedicaid Program – Administrative Costs Used in Premium Rate Setting of Mainstream Managed Care Organizations
… State Medicaid program is administered by the Department. For the State fiscal year ended March 31, 2015, New York’s … Under managed care, Medicaid pays MCOs a monthly premium for each enrolled Medicaid recipient, and the MCOs arrange … MCOs received $17.8 billion in mainstream managed care premiums for nearly 5.2 million Medicaid enrollees. The …
https://www.osc.ny.gov/state-agencies/audits/2017/09/13/medicaid-program-administrative-costs-used-premium-rate-setting-mainstream-managed-careState Comptroller DiNapoli Releases Audits
… the department has the authority to disenroll recipients from their managed care plan into FFS. The Families First Coronavirus Response Act, … medical assistance to state Medicaid programs, but also required states to maintain managed care coverage for …
https://www.osc.ny.gov/press/releases/2022/12/state-comptroller-dinapoli-releases-auditsOverpayments of Claims for Selected Professional Services (Follow-Up)
… in our initial audit report, Overpayments of Claims for Selected Professional Services (Report 2010-S-73). … examined whether inappropriate Medicaid payments were made for selected providers who also received payments from Medicare. For the two year audit period ended December 31, …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followAlternatives For Children – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Alternatives For Children (Alternatives) on its Consolidated Fiscal … special education services through rates set by SED. The reimbursement rates are based on financial information, …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/alternatives-children-compliance-reimbursable-cost-manualVII.10.E Cash Advance Reimbursement – VII. State Revenues and Appropriated Loan Receivables
… Advance Account of this Guide for further information. It is not appropriate to use the advance account codes … reviews and approves the payment, an ACH payment is made to the agency’s bank account. For salary advance …
https://www.osc.ny.gov/state-agencies/gfo/chapter-vii/vii10e-cash-advance-reimbursementCVS Health – Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil Service
… Objective To determine if CVS Health appropriately invoiced drug manufacturers and remitted corresponding rebate revenue to the Department of Civil Service for prescription drugs provided under the Empire Plan Medicare Rx drug benefit. Our audit …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/cvs-health-accuracy-empire-plan-medicare-rx-drug-rebate-revenue-remitted-department-civilMay 1998: Accounting Requirements and Program Information for Multi-Modal Transportation Program
… signed into law in a Memorandum of Understanding (MOU). All allocations or reallocation of Multi-Modal funding must … and the Speaker of the Assembly. Project Eligibility - All Mutli-Modal projects must meet the following general … on a quarterly basis (February, May, August, November) for all eligible costs of previously unreimbursed expenditures. …
https://www.osc.ny.gov/local-government/publications/may-1998-accounting-requirements-and-program-information-multi-modal-transportation-programState Agencies Bulletin No. 914
… procedures regarding withholding of Social Security and Medicare taxes for employees receiving a military stipend. Affected … military stipend payments made to employees in active duty for more than 30 days are to be treated as wages, subject to …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/914-change-taxation-military-stipendsPrograms for Little Learners – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Programs For Little Learners (PFLL) on its Consolidated Fiscal Reports … special education services through rates set by SED. The reimbursement rates are based on financial information, …
https://www.osc.ny.gov/state-agencies/audits/2018/09/24/programs-little-learners-compliance-reimbursable-cost-manualState Agencies Bulletin No. 468
… and Medicare tax refunds. Effective Date(s) Checks dated April 15, 2004 for Institution agencies and checks dated April 21, 2004 for Administration agencies. Background Effective …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/468-new-earnings-codes-current-year-social-security-and-medicare-adjustmentsState Agencies Bulletin No. 982
… inform agencies of the automatic correction of Form W-2s for employees who received Military Stipend Earnings in 2006, … Stipend earnings that were subject to Social Security and Medicare tax withholdings beginning in 2006 through 2009 … with tax year 2006. There will be no direct deposit for this refund check. OSC will provide agencies a list of …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/982-social-security-and-medicare-tax-refunds-and-corresponding-correctedEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… whether Empire BlueCross BlueShield's (Empire) payments for certain special items were reasonable in relation to the … for special items submitted by hospitals that did not have reimbursement limitations. Key Findings Empire made excessive … hospitals contain language which specifies the basis of reimbursement for special items. Develop and implement a …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughRetiree Annual Statement
… button. If Retirement System is blank, click Look Up icon and select ERS or PFRS from dialog box. Click Look Up … your personal information is secure. Use it when you call or write NYSLRS. Benefit Amount Base Benefit Your total … (Return to Top) View Your Pension Pay Stub for Year-to-Date Information Your pay stub gives you valuable insight …
https://www.osc.ny.gov/retirement/retirees/retiree-annual-statementImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… in our initial audit report, Improper Medicaid Payments for Recipients in Hospice Care ( 2017-S-76 ). About the … elect hospice care, they waive their right to use Medicaid for curative services and a hospice organization assumes … However, if a Medicaid recipient is also enrolled in Medicare, Medicare is the primary payer and Medicaid is the …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followMedicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY (Follow-Up)
… in our initial audit report, Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-part-b-services-billed-directly-emedny-followState Comptroller DiNapoli Releases Audits
… Learning – Compliance With the Reimbursable Cost Manual (2022-S-7) Cantalician, a not-for-profit special education … Inc. – Compliance With the Reimbursable Cost Manual (2022-S-23) Abilities First, Inc. (AFI) is a not-for-profit … Hospice Services Covered by Medicare (Follow-Up) (2022-F-31) A prior audit report, issued in December 2020, …
https://www.osc.ny.gov/press/releases/2023/02/state-comptroller-dinapoli-releases-auditsTown of Essex – Internal Controls Over Selected Financial Operations (2015M-60)
… internal controls over selected financial operations for the period January 1, 2013 through October 31, 2014. … district and one sewer district. Budgeted appropriations for 2014 totaled approximately $1.22 million. Key Findings … tax withholdings and deductions for health insurance premiums. Not all employees’ leave accrual records were …
https://www.osc.ny.gov/local-government/audits/town/2015/08/07/town-essex-internal-controls-over-selected-financial-operations-2015m-60