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Medicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… Objective To determine whether Medicaid overpayments for inpatient services on behalf of managed care recipients … pays managed care organizations (MCOs) a monthly premium for each enrolled recipient. In turn, the MCOs are required to pay for the services their recipients require, including …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsMedicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
… programs’ laws or regulations. The Department terminated 18 of the providers we identified, but the status of six … Claims Processing Activity October 1, 2012 Through March 31, 2013 (2012-S-131) … To determine whether the …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013New York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… Objective To assess the extent of implementation of the five recommendations … (Report 2019-S-32 ). About the Program The New York State Health Insurance Program (NYSHIP), administered by the … health insurance coverage to over 1.2 million active and retired State, local government, and school district …
https://www.osc.ny.gov/state-agencies/audits/2021/12/27/new-york-state-health-insurance-program-payments-empire-bluecross-hospital-servicesMedicaid Program – Improper Overlapping Medicaid and Essential Plan Enrollments
… Force Closure processing weaknesses, NYSOH flaws with assigning multiple recipient identification numbers, and …
https://www.osc.ny.gov/state-agencies/audits/2022/10/11/medicaid-program-improper-overlapping-medicaid-and-essential-plan-enrollmentsEldred Central School District – Budget Review (B4-15-3)
… in real property taxes, which complies with the tax cap limits established by law. Key Recommendations Reevaluate …
https://www.osc.ny.gov/local-government/audits/school-district/2015/04/08/eldred-central-school-district-budget-review-b4-15-3Costs to Administer the Insurance Division Operations for the Three Fiscal Years Ended March 31, 2012
… the Insurance Division's costs by adjusting to the current year (2012-2013) assessment. Key Recommendation Take …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/costs-administer-insurance-division-operations-three-fiscal-years-ended-march-31-2012Village of West Haverstraw - Accrued Leave and Benefits (2019M-143)
… and used for administrative employees, or the amount of sick leave accrued and to be carried over to the next … Key Recommendations Adopt procedures for the maintenance of time and accrual records, including approving and monitoring of the records. Establish procedures that help ensure benefit …
https://www.osc.ny.gov/local-government/audits/village/2019/09/06/village-west-haverstraw-accrued-leave-and-benefits-2019m-143State Contract and Payment Actions in May
… gaming revenue distributions for the del Lago Resort and Casino, Rivers Casino and Resort, Tioga Downs Casino, and Resorts World Catskills. Office of General …
https://www.osc.ny.gov/press/releases/2024/07/state-contract-and-payment-actions-mayState Contract and Payment Actions in September
… products in Monroe County. $1.9 million to La Plaza de Virginia Owners LLC for a portion of the demolition and …
https://www.osc.ny.gov/press/releases/2023/11/state-contract-and-payment-actions-septemberState Contract and Payment Actions in December
… contracts and payments is available at www.openbooknewyork.com . The Governor’s Executive Order 202 suspended the Office … of contracts related to the COVID-19 crisis until Feb. 26, 2021. At the administration's request, OSC has been …
https://www.osc.ny.gov/press/releases/2021/02/state-contract-and-payment-actions-decemberUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… between $1.6 million and $5.2 million during the one-year period ending August 31, 2013 because providers …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59State Contract and Payment Actions in February
… gaming revenue distributions for the del Lago Resort and Casino, Rivers Casino and Resort, Tioga Downs Casino, and Resorts World Catskills. $7.6 million for …
https://www.osc.ny.gov/press/releases/2024/04/state-contract-and-payment-actions-februaryState Contract and Payment Actions in November
… on these contracts and payments is available at Open Book New York . Major Contracts Approved Department of Environmental … personal income tax refunds. $258.3 million for 19,564 corporate and other tax refunds. $9.5 million for 10,335 …
https://www.osc.ny.gov/press/releases/2025/01/state-contract-and-payment-actions-novemberState Agencies Bulletin No. 1118
… employers are required to furnish each employee with a Form W-2 by January 31, 2012. Effective Date(s) 2011 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1118-form-w-2-wage-and-tax-statement-calendar-year-2011State Agencies Bulletin No. 1220
… employers are required to furnish each employee with a Form W-2 by January 31, 2013. 2012 Form W-2 Content …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1220-form-w-2-wage-and-tax-statement-calendar-year-2012UnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… rate schedules that did not correlate with the date of the service on the claims, and to calculate the … Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance … United to administer the medical/surgical benefits portion of the Empire Plan. United contracts with in-network …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsCVS Caremark – Accuracy of Empire Plan Commercial Rebate Revenue Remitted to the Department of Civil Service
… December 2022. About the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to about 1.2 million active and …
https://www.osc.ny.gov/state-agencies/audits/2025/03/18/cvs-caremark-accuracy-empire-plan-commercial-rebate-revenue-remitted-department-civilUlster County Community College - Retiree Health Insurance and Payroll (2018M-123)
Ulster County Community College - Retiree Health Insurance and Payroll (2018M-123)
https://www.osc.ny.gov/files/local-government/audits/pdf/ulster-county.pdfOpinion 95-1
… (municipality's responsibility to pay health care cost of urban renewal agency employees) MUNICIPAL … §§503-a, 554: A city is not responsible for paying the cost of health care benefits to retirees of a city urban … and ask whether the city is responsible for paying the cost of these benefits in the event the agency has …
https://www.osc.ny.gov/legal-opinions/opinion-95-1Medicaid Program – Claims Processing Activity October 1, 2022 Through March 31, 2023
… Objective To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … were processed in accordance with Medicaid requirements, and resulted in correct payments to providers. The audit …
https://www.osc.ny.gov/state-agencies/audits/2023/10/25/medicaid-program-claims-processing-activity-october-1-2022-through-march-31-2023