Reimbursement for Medicare / Medicaid in New York

Beginning July 1, 2015, Medicaid is no longer reimbursing partial Medicare Part B coinsurance amounts. The total Medicare/Medicaid payment to the provider will not exceed the amount that the provider would have received for a Medicaid-only patient. If the Medicare payment is greater than the Medicaid fee, no additional payment will be made

Here is a link with more information

https://www.health.ny.gov/health_care/medicaid/program/update/2015/jun15_mu.pdf

Beginning April 1, 2016, Medicaid will reimburse at the rate of eighty-five percent (85%) of the Medicare Part C  (Medicare Advantage or Medicare managed care)  copayment or coinsurance amount.

Here is a link with more information

https://www.health.ny.gov/health_care/medicaid/program/update/2016/2016-07.htm

https://www.emedny.org/Listserv/eMedNYGeneralUpdates/Change_to_Medicaid_Reimbursement_of_Medicare_Part_C_Co-payment_and_Co-insurance_Liabilities_8-09-16.pdf

Here is NY state report about how Medicaid made excessive payments for Medicare Part C cost-sharing liabilities

https://osc.state.ny.us/audits/allaudits/093014/12s133.pdf