New York State Comptroller Thomas P. DiNapoli announced today the following audits have been issued.

Department of Health (DOH): Excessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (2021-S-37)

For individuals enrolled in Medicaid managed care, the department pays for services through monthly premium payments to managed care organizations. Where managed care premiums exceed the cost of deductibles and coinsurance that Medicaid would be obligated to pay under the fee-for-service (FFS) method of payment, the department has the authority to disenroll recipients from their managed care plan into FFS. The Families First Coronavirus Response Act, enacted in response to the coronavirus disease 2019 state of emergency, increased the federal medical assistance to state Medicaid programs, but also required states to maintain managed care coverage for enrolled recipients throughout the public health emergency. In November 2020, the regulation was amended to end the pause, allowing states to change a recipient’s eligibility group as long as minimum essential coverage was maintained. For the period March 2021 through March 2022, auditors identified over $194.1 million in excessive Medicaid managed care premium payments made on behalf of recipients who should have been, but were not, disenrolled from managed care into FFS, as allowed by federal regulations.

Department of Environmental Conservation (DEC): Compliance With Executive Order 95 (Open Data) (Follow-Up) (2022-F-20)

The initial audit, issued in May 2021, found that although DEC had taken steps to comply with EO 95, certain requirements had not been fully addressed. Among other issues, DEC did not identify the total population of state data it maintains, providing limited assurance it created a complete catalogue of its publishable state data or accompanying schedules for making that data public. In their follow-up, auditors found DEC made progress addressing the issues identified in the initial audit and implemented both recommendations from that report.

State Education Department (Preschool Special Education Audit Initiative): St. Mary’s Hospital for Children, Inc. – Compliance With the Reimbursable Cost Manual (2021-S-38)

St. Mary’s is a not-for-profit organization authorized by the State Education Department (SED) to provide full-day special class services to children with disabilities between the ages of 3 and 4 years. For the three fiscal years ended December 31, 2019, St. Mary’s reported approximately $12 million in reimbursable costs for the SED preschool cost-based program. Auditors identified $257,142 in costs that did not comply with SED’s requirements for reimbursement.

Metropolitan Transportation Authority (MTA): Selected Aspects of the All-Agency Contractor Evaluation (ACE) System at Long Island Rail Road, Metro-North Railroad, New York City Transit, and Triborough Bridge and Tunnel Authority (2019-S-52)

MTA implemented the ACE performance evaluation system as a means for component agencies to report on contractor and consultant performance and share the results with each other. ACE ratings must be reviewed when determining whether to award additional contracts where the same contractor is party to a new contract (either alone or in a joint venture). Unsatisfactory or repeated marginal ratings can hinder a contractor from being deemed “responsible” to take on new contract work. The audit found that MTA did not properly handle the review of responsibility for two of 10 sampled contractors with repeated less-than-satisfactory ACE ratings when awarding new contracts. MTA missed opportunities to advise project management teams about areas of known performance issues with contractors when they were awarded new contracts. Further, MTA did not ensure that ACE ratings were performed timely by evaluators who were responsible for the project or, in certain cases, that the evaluations were done at all.

Department of Motor Vehicles: Assessable Expenses of Administering the Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act for the State Fiscal Year Ended March 31, 2022 (2022-M-1)

The Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act (collectively, Acts) help ensure that the operators of motor vehicles driven in New York State possess adequate insurance coverage, or are financially secure, to compensate those persons they might injure or whose property they might damage as a result of an accident. The Department of Motor Vehicles is responsible for tracking the expenses of administering the Acts and assessing these expenses on insurance carriers that issue policies or contracts of automotive bodily injury insurance. Auditors found that the expenses for administering the Acts for the State Fiscal Year ended March 31, 2022 totaled $22.3 million.

Office of Mental Health (OMH): Oversight of Telemental Health Services (2022-F-22)

Telemental health (TMH) uses two-way, real-time interactive audio and video equipment to provide and support mental health services and psychiatric care at a distance – a method particularly critical during the COVID-19 pandemic. The initial audit, issued in June 2021, found that OMH could do more to ensure the ongoing availability of TMH by approved providers as well as TMH providers’ compliance with TMH regulations. The follow-up found that OMH made significant progress in addressing the problems identified, and implemented all three of OSC’s recommendations.

State Education Department (Preschool Special Education Audit Initiative): The Arc Erie County New York – Compliance With the Reimbursable Cost Manual (2022-S-10)

Arc Erie, a not-for-profit special education provider located in Williamsville, is authorized by the State Education Department (SED) to provide preschool special education services to children with disabilities who are between 3 and 4 years of age. For the fiscal year ended June 30, 2019, Arc Erie reported approximately $3.6 million in reimbursable costs for its two rate-based preschool special education programs: Preschool Special Class (over 2.5 hours per day) and Preschool Integrated Special Class (over 2.5 hours per day). Auditors identified $8,724 in costs that did not comply with SED’s requirements for reimbursement.

Track state and local government spending at Open Book New York. Under State Comptroller DiNapoli’s open data initiative, search millions of state and local government financial records, track state contracts, and find commonly requested data.