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State Agencies Bulletin No. 1035
… agencies that earnings code CFR (CLEFR) should be used for the taxable fringe benefit CLEFR and how it will be … the PEF, M/C or CSEA Certification, Licensure and Exam Fee Reimbursement Program Effective Date(s) Institution paychecks … is subject to Federal, State, Local, Social Security and Medicare Taxes. “CFR” and the amount will appear on the …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1035-certification-licensure-and-exam-fee-reimbursement-clefr-2010Medicaid Program – Overpayments for Medicare Part C Claims
… services occurred in part because hospitals misinterpreted State regulations and billing guidelines, did not properly …
https://www.osc.ny.gov/state-agencies/audits/2024/12/04/medicaid-program-overpayments-medicare-part-c-claimsOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in … Part B (2010-S-50). Background Many of the State's Medicaid recipients are also eligible for Medicare Part B, … referred to as "dual eligible." Generally, Medicare is the primary payer of claims for services provided to …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followMedicaid Program – Improper Supplemental Maternity Capitation Payments to Managed Care Organizations
… pays managed care organizations (MCOs) a monthly premium for each enrolled recipient and, in turn, the MCOs pay for … services their members require. In addition to the monthly premiums, MCOs can receive a one-time Supplemental Maternity … encounter data to verify that SMCP claims are eligible for reimbursement. Instead, the Department relies on audits by …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-supplemental-maternity-capitation-payments-managed-careCost Saving Opportunities on Payments of Medicare Part C Claims (2020-S-65) 180-Day Response
To determine whether Medicaid cost savings can be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with federal requirements.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-20s65-response.pdfMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… of Health overpaid health care providers’ Medicaid claims for services also covered by Medicare Advantage plans. The audit covered the period from …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesMedicaid Program – Overpayments for Services Also Covered by Medicare Part B
… if the Department of Health overpaid health care providers for Medicaid claims for Medicare Part B coinsurance. The audit covers the period …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-program-overpayments-services-also-covered-medicare-part-bOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… two recommendations made in our audit report, Overpayments for Services Also Covered by Medicare Part B (Report 2012-S-27). Background Many of the …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followState Agencies Bulletin No. 1043
… 3 and 5) Box 13 Checkboxes A check mark is placed in the Retirement Plan box and/or the Third Party Sick Pay box if … contributions for employees with Domestic Partner Health Insurance. WCX - Workers’ Compensation excluded amount. This …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1043-form-w-2-wage-and-tax-statement-calendar-year-2010State Agencies Bulletin No. 950
… 3 and 5) Box 13 Checkboxes A check mark is placed in the Retirement Plan box and/or the Third Party Sick Pay box if … contributions for employees with Domestic Partner Health Insurance. WCX Workers’ Compensation excluded amount. This is …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/950-form-w-2-wage-and-tax-statement-calendar-year-2009Medicaid Overpayments for Medicare Advantage Plan Services (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations included in our initial audit report, Medicaid Overpayments for Medicare Advantage Plan Services … the State’s Medicaid program. Many Medicaid recipients are also enrolled in Medicare Part C, commonly referred to as …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followMedicaid Program – Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus
… plans and Family Health Plus managed care plans (Plans) for recipients who were no longer enrolled. Our audit covered … managed care plans receive monthly premium payments for individuals enrolled in their plans. In return, managed … Plans can either void their claims for the improperly paid premiums or refund the inappropriate premiums by check. Key …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/medicaid-program-inappropriate-premium-payments-recipients-no-longer-enrolled-mainstreamExamination of Outstanding Premiums
… Offset Program (SWOP), and (ii) the amount of outstanding premiums NYSIF may have been able to recover through SWOP … Background New York State businesses pay NYSIF premiums for workers compensation and disability insurance. If a … by the Department of Tax and Finance (DTF), is a way for State agencies to offset State payments to recover …
https://www.osc.ny.gov/state-agencies/audits/2016/08/19/examination-outstanding-premiumsOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… included in our initial audit report, Overpayments for Therapy Services and Prescription Drugs Covered by Medicare (Report 2016-S-73 ). About the Program The New York …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followMedicaid Program – Overpayments for Therapy Services and Prescription Drugs Covered by Medicare
… of Health overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered by Medicare. The audit covered the period January 1, 2012 to …
https://www.osc.ny.gov/state-agencies/audits/2019/10/30/medicaid-program-overpayments-therapy-services-and-prescription-drugs-covered-medicareImproper Medicaid Payments Involving Fee-for-Service Claims for Recipients With Multiple Client Identification Numbers (Follow-Up)
… audit report, Improper Medicaid Payments Involving Fee-for-Service Claims for Recipients With Multiple Client … may enroll in Medicaid through Local Departments of Social Services or the NY State of Health (the State’s online … for Medicaid benefits is assigned a Client Identification Number (CIN), a unique identifier. Medicaid recipients may …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/improper-medicaid-payments-involving-fee-service-claims-recipients-multiple-clientState Comptroller DiNapoli Releases Audits
… today the following audits have been issued. Office for the Aging (OFA): Long-Term Care Ombudsman Program (Follow … family coverage during the audit period. The total cost of premiums to the members and participating organizations for … $23,616 in ineligible costs Kelberman reported for reimbursement. State Education Department (SED): Kids …
https://www.osc.ny.gov/press/releases/2021/01/state-comptroller-dinapoli-releases-auditsMedicaid Program – Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY
… Many of the State’s Medicaid recipients are also eligible for Medicare, the federal health insurance program for people age 65 or older and people under 65 with certain …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-part-b-services-billed-directly-emednyComptroller DiNapoli Releases State Audits
… the risk that equipment may be misappropriated, or used for personal use. In a follow-up, auditors found the … State Department of Health: Medicaid Payments for Medicare Part A Beneficiaries (Follow-Up) (2013-F-16) An … to pay Medicaid claims in accordance with Medicaid reimbursement policies. During the audit period, eMedNY …
https://www.osc.ny.gov/press/releases/2014/04/comptroller-dinapoli-releases-state-auditsState Comptroller DiNapoli Releases Audits
… – Anthem Blue Cross – Coordination of Benefits With Medicare (2023-S-3) The Empire Plan is the primary health … insurance coverage in addition to the Empire Plan such as Medicare. Coordination of benefits is a process health … system was not always updated promptly with members’ Medicare-related information, and weaknesses in Anthem’s and …
https://www.osc.ny.gov/press/releases/2024/08/state-comptroller-dinapoli-releases-audits