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Madrid-Waddington Central School District - Claims Audit Process (2019M-1)
… Determine whether claims were adequately documented, were for appropriate purposes and were properly audited and … two claims totaling $251,601 for health insurance and Medicare reimbursement. In addition, two claims totaling $17,848 were …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (2020-S-35) 180-Day Response
To determine if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in the Medicare buy-in program.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-20s35-response.pdfMedicaid Program – Cost Saving Opportunities on Payments of Medicare Part C Claims
… Medicaid cost savings can be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-cost-saving-opportunities-payments-medicare-part-c-claimsMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… claims for ancillary services in accordance with Medicaid reimbursement policies. The audit covers the period April 1, … service claims for recipients who were also covered by Medicare. Key Recommendations Recover the $1 million in … ancillary services provided to recipients also covered by Medicare. Enhance existing eMedNY edits or implement new …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… disadvantaged and/or have special health care needs. For the State fiscal year ended March 31, 2015, New York’s … MCOs received $17.8 billion in mainstream managed care premiums for nearly 5.2 million Medicaid enrollees. The … The Department is required by the federal Centers for Medicare & Medicaid Services to create actuarially sound …
https://www.osc.ny.gov/state-agencies/audits/2016/10/13/medicaid-program-mainstream-managed-care-organizations-administrative-costs-used-premiumNew York State Comptroller Thomas P. DiNapoli Statement on Federal Tax Reform
… "The Republican tax bill moving forward in Congress remains a bad deal for New York. "The cap on state and local tax deductions would … higher health insurance premiums or loss of coverage for many New Yorkers. "The legislation will drive up the cost of …
https://www.osc.ny.gov/press/releases/2017/12/new-york-state-comptroller-thomas-p-dinapoli-statement-federal-tax-reform-0Medicaid Program – Medicaid Payments Made Pursuant to Medicare Part C
… Purpose To determine if Medicaid made excessive payments for Medicare Part C cost-sharing liabilities. The audit covered … enrolled in Part C. Key Recommendations Re-evaluate the reimbursement methodology for Medicare Part C cost-sharing, …
https://www.osc.ny.gov/state-agencies/audits/2014/05/09/medicaid-program-medicaid-payments-made-pursuant-medicare-part-cDiNapoli: Medicaid Audits Find Nearly $800 Million in Savings and Revenue
… “New York state faces a projected budget gap of $6 billion for the coming fiscal year, in part because of higher … or disabled. Medicaid pays MLTC plans monthly managed care premiums and, in return, MLTC plans pay for all MLTC covered … MLTC services as the responsibility of the MLTC plan. Medicare Part D Clawback Payments (2018-S-46) Under federal …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-medicaid-audits-find-nearly-800-million-savings-and-revenueState Agencies Bulletin No. 1434
… agencies with the 2015 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … in box 1 on the employee’s 2015 Form W-2. Social Security/Medicare tax deficiency deductions will be initiated for any …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1434-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1513
… agencies with the 2016 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … in box 1 on the employee’s 2016 Form W-2. Social Security/Medicare tax deficiency deductions will be initiated in early …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1513-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1356
… agencies with the 2014 calendar year-end procedures for taxable travel reimbursement. Background Taxable travel reimbursements … in box 1 on the employee’s 2014 Form W-2. Social Security/Medicare tax deficiency deductions will be initiated for any …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1356-year-end-procedure-taxable-employee-expense-reimbursementsOverpayments of Certain Medicare Crossover Claims
… Purpose To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify … adjustment codes; and did not properly apply Medicaid reimbursement limits. The potential overpayments totaled …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsState Agencies Bulletin No. 1674
… in box 1 on the employee’s 2018 Form W-2. Social Security/Medicare tax deficiency deductions will be initiated in early … ($7,960.80) for 2018 will only have a deduction for the Medicare tax deficiency in a 2018 paycheck. Tax Information … for 2018 and subsequent deductions for Social Security and Medicare tax deficiencies in 2019, Payroll Officers should …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1674-year-end-procedure-taxable-employee-expense-reimbursementsState Agencies Bulletin No. 1596
… in box 1 on the employee’s 2017 Form W-2. Social Security/Medicare tax deficiency deductions will be initiated in early … ($7,886.40) for 2017 will only have a deduction for the Medicare tax deficiency in a 2018 paycheck. Tax Information … for 2017 and subsequent deductions for Social Security and Medicare tax deficiencies in 2018, Payroll Officers should …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1596-year-end-procedure-taxable-employee-expense-reimbursementsChildren's Development Group, PLLC – Compliance With the Reimbursable Cost Manual
… The audit covered costs reported on CDG’s CFR for the reporting year ended June 30, 2016. About the Program … CDG reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with SED’s … in other than personal service costs – such as insurance premiums and property lease payments – that did not meet one …
https://www.osc.ny.gov/state-agencies/audits/2019/12/11/childrens-development-group-pllc-compliance-reimbursable-cost-manualMedicaid Program – Medicaid Claims Processing Activity October 1, 2017 Through March 31, 2018
… system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients, and it … as follows: $107.7 million in Medicaid managed care premiums were paid on behalf of recipients with concurrent … had; $2.1 million was paid for claims involving the Medicare Savings Program; $1.7 million in fee-for-service …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/medicaid-program-medicaid-claims-processing-activity-october-1-2017-through-march-31-2018Medicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… Purpose To determine whether Medicaid made improper fee-for-service claim payments for pharmacy services covered by … were covered by managed care plans, and fee-for-service reimbursement was no longer appropriate for recipients … 31, 2013, Medicaid paid approximately $46.5 billion in premiums to 92 MCO plans. Key Findings Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careState Health Department Unnecessarily Paid over $1 Billion for Patients Covered by Private Insurance
… paid $1.28 billion in unnecessary Medicaid managed care premiums over a nearly six-year period for enrollees who already had private insurance, according to … disadvantaged or have special health care needs. For the state fiscal year ended March 31, 2017, New York's …
https://www.osc.ny.gov/press/releases/2018/06/state-health-department-unnecessarily-paid-over-1-billion-patients-covered-private-insuranceState Agencies Bulletin No. 1031
… relating to taxable travel reimbursements in order for the State to comply with IRS reporting requirements. This … XI, Section 8 . CAS/PayServ Processing Taxable travel reimbursement data is transferred from the Central Accounting … In early 2011, PayServ will initiate Social Security/Medicare tax deficiency deductions that apply to the 12/11/10 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1031-year-end-procedure-taxable-travel-reimbursementState Agencies Bulletin No. 1093
… relating to taxable travel reimbursements in order for the State to comply with IRS reporting requirements. This … XI, Section 8 . CAS/PayServ Processing Taxable travel reimbursement data is transferred from the Central Accounting … In early 2012, PayServ will initiate Social Security/Medicare tax deficiency deductions that apply to the 12/10/11 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1093-year-end-procedure-taxable-travel-reimbursements