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Improper Managed Care Premium Payments for Recipients With Duplicate Client Identification Numbers (Follow-Up)
… Care Premium Payments for Recipients With Duplicate Client Identification Numbers (Report 2018-S-24 ). About the … individual who applies for Medicaid benefits is assigned a Client Identification Number (CIN), a unique identifier. … Care Premium Payments for Recipients With Duplicate Client Identification Numbers Report 2018S24 …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/improper-managed-care-premium-payments-recipients-duplicate-client-identification-numbersMedicaid Program: Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare (2021-S-16)
To determine whether the Department of Health (Department) took sufficient steps to control the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-21s16.pdfOversight of Managed Long-Term Care Member Eligibility (Follow-Up)
… processing the disenrollments. The Department can recover premium payments made to MLTC plans for ineligible enrollees. … was to determine whether the Department made improper MLTC premium payments on behalf of ineligible enrollees. The audit … we determined Medicaid paid $2.8 billion in MLTC premium payments on behalf of 51,947 recipients who received …
https://www.osc.ny.gov/state-agencies/audits/2024/03/13/oversight-managed-long-term-care-member-eligibility-followState Agencies Bulletin No. 1223
… Purpose To inform agencies of the tax related withholding requirements for 2013. Effective … Paychecks dated after January 1, 2013 Social Security Tax The Social Security wage base limit will increase to … 2013. The temporary reduction in Social Security payroll tax rate (4.2%) for employees expires December 31, 2012. …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1223-summary-tax-related-withholding-requirements-2013Improper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… Objective To determine the extent of implementation of the 11 recommendations made in our initial audit report, … the dual-enrolled recipients’ cost-sharing obligations of copayments, deductibles, and coinsurance. We issued our … To determine the extent of implementation of the 11 recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… do not have such limitations. From January 1, 2011 to March 31, 2011, Empire paid $24 million for 12,990 claims for …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughMedicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY (Follow-Up)
… initial audit. For instance, the Department implemented a new claim processing control to prevent payment of excessive …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-part-b-services-billed-directly-emedny-followCosts to Administer the Insurance Division Operations for the Three Fiscal Years Ended March 31, 2012
… Purpose To determine whether the Department of Financial Services (Department) is … expenses accurately, pursuant to Section 332, Article 3 of the Insurance Law. Our audit covered the period April 1, 2009 through March 31, 2012. Background … To determine whether the Department of Financial Services Department is reporting …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/costs-administer-insurance-division-operations-three-fiscal-years-ended-march-31-2012School for Language and Communication Development – Compliance With the Reimbursable Cost Manual
… provides preschool special education services to children with disabilities who are between three and five years of … be eligible for reimbursement, reported costs must comply with the RCM requirements. For the three fiscal years ended … the Programs. The ineligible costs included: $28,271 in pension benefits for administrative employees that exceeded …
https://www.osc.ny.gov/state-agencies/audits/2018/04/16/school-language-and-communication-development-compliance-reimbursable-cost-manualBloomingburg Fire Company #1 – Disbursements (2013M-83)
… Purpose of Audit The purpose of our audit was to evaluate the internal controls over the … #1 is a volunteer organization located in the Village of Bloomingburg in Sullivan County. The Company officers … The purpose of our audit was to evaluate the internal controls over the …
https://www.osc.ny.gov/local-government/audits/fire-district/2013/06/28/bloomingburg-fire-company-1-disbursements-2013m-83Improper Medicaid Payments for Misclassified Patient Discharges (Follow-Up)
… provides the basis for calculating the reimbursement. When a hospital bills Medicaid for an inpatient stay, the … services received as well as the date of the admission and when the services ended. Hospitals also report patient status …
https://www.osc.ny.gov/state-agencies/audits/2023/01/18/improper-medicaid-payments-misclassified-patient-discharges-followAnthem Blue Cross – Coordination of Benefits With Medicare
… plan. This process determines which insurance plan pays first as primary and which insurance plan pays secondary. Because the insurance company which pays primary typically pays the majority of the claim, it is …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareCambridge Central School District - Medicaid Reimbursements (2019M-109)
… for all eligible services provided. Review all unclaimed services, determine whether these services are …
https://www.osc.ny.gov/local-government/audits/school-district/2019/08/23/cambridge-central-school-district-medicaid-reimbursements-2019m-109CUNY Bulletin No. CU-531
… Purpose To inform agencies of the new flat rate deduction codes that will be used to recover … To inform agencies of the new flat rate deduction codes that will be used to recover …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-531-new-deduction-codes-580-city-university-new-york-medicareMedicaid Program – Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare (2021-S-16) 180-Day Response
To determine whether the Department of Health (Department) took sufficient steps to control the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-21s16-response.pdfIX.5.B Billing for Onboarding Agencies – IX. Federal Grants
… run to create the corresponding Accounts Receivable (AR) for the award. This AR amount then populates the drawdown worksheets. The … bills which results in an outstanding Accounts Receivable (AR) for the award. This AR amount then populates the drawdown …
https://www.osc.ny.gov/state-agencies/gfo/chapter-ix/ix5b-billing-onboarding-agenciesThree Town Fire District - Board Oversight of Financial Activities (2018M-106)
… insurance premiums totaling $43,334 that included coverage for property and equipment not owned by the District. Key …
https://www.osc.ny.gov/local-government/audits/fire-district/2018/09/07/three-town-fire-district-board-oversight-financial-activities-2018m-106Four Individuals Charged in Widespread Scheme to Defraud Medicare and Other Health Insurance Providers Through Fraudulent Medical Corporations and False Billing Resulting in Tens of Millions of Dollars in Losses
… State Comptroller Thomas P. DiNapoli, Geoffrey S. Berman, the United States Attorney … has been assigned to U.S. District Court Judge Kenneth M. Karas. Berman also today announced the guilty plea of … State Comptroller Thomas P DiNapoli announced the unsealing today of an indictment …
https://www.osc.ny.gov/press/releases/2018/08/four-individuals-charged-widespread-scheme-defraud-medicare-and-other-health-insurance-providersSolvay Union Free School District – Payroll (2017M-257)
… approximately $32.4 million. Key Findings Except for minor discrepancies, the employee salaries and wages we …
https://www.osc.ny.gov/local-government/audits/school-district/2018/02/02/solvay-union-free-school-district-payroll-2017m-257Cost-Saving Ideas: Containing Employee Health Insurance Costs
… As an employer, you should always look for ways to contain health insurance … Review the practices below and determine whether they can achieve cost savings and still provide the right coverage … Cash Payment In Lieu of Health Benefits For employees who have coverage available under a spouse’s plan or another …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-containing-employee-health-insurance-costs