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Selected Payments for Special Items Made to St. Peter's Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield's (Empire's) payments to St. Peter's Hospital (St. Peter's) for special items were made according to the provisions of the agreement between Empire and St. Peter's. Background The New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Assessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… Purpose The purpose of this performance audit is to determine whether the Workers’ Compensation Board … 2014. Background The primary responsibility of the Board is to ensure that employees who are unable to work due to … Coverage for these benefits, with limited exception, is to be provided by their employers. The Board is also …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Identifying, Reporting, and Providing Services for Youth at Risk of Sexual Human Trafficking in New York City
… for Children’s Services and the New York City Department of Youth and Community Development identify, report on, and provide services for victims of child sex trafficking and those at risk of child sex trafficking. The audit covered the period from … for Childrens Services and the New York City Department of Youth and Community Development identify report on and …
https://www.osc.ny.gov/state-agencies/audits/2022/06/06/identifying-reporting-and-providing-services-youth-risk-sexual-human-trafficking-new-yorkMedicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… Objective To determine whether Medicaid overpayments for pharmacy services on behalf of managed care recipients who … Medicaid services their recipients require, which includes pharmacy services. Many recipients have other third-party … audit period, HMS’ third-party liability recoveries on MCO pharmacy payments totaled about $118 million. Key Findings We …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsNew York City Department of Homeless Services – Oversight of Contract Expenditures of Institute for Community Living, Inc.
… services for eligible homeless families and individuals in New York City (City) and for providing fiscal oversight of the homeless shelters. In March 2014, DHS contracted with ICL, a City-based … years ended June 30, 2019, ICL claimed $24.5 million in reimbursable expenses for the contract. DHS is responsible …
https://www.osc.ny.gov/state-agencies/audits/2022/09/16/new-york-city-department-homeless-services-oversight-contract-expenditures-instituteSelected Aspects of Leasing Practices for Real Estate Department, Aviation, World Trade Center, and Leasing of Properties
… opportunities and whether PANYNJ followed its procedures in the leasing of properties. This audit covered the period … New York and New Jersey, the Port Authority Bus Terminal in Manhattan, the George Washington Bridge Bus Station, and … leases early, and other percentages of revenues specified in leases. During our audit scope, PANYNJ’s Real Estate …
https://www.osc.ny.gov/state-agencies/audits/2021/05/04/selected-aspects-leasing-practices-real-estate-department-aviation-world-trade-center-andMedicaid Program – Improper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements
… NPI identified by the audit and determine an appropriate course of action. Enhance system controls to prevent improper …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-claims-not-compliance-ordering-prescribingInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… During the initial audit period, Family Health Plus (FHP) was a publicly funded managed care program for … eliminated effective January 1, 2015 and the majority of FHP enrollees transitioned to the Medicaid program. Managed … payments to Medicaid mainstream managed care plans and FHP managed care plans for recipients who were no longer …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… of deductibles and coinsurance that Medicaid would pay on FFS claims for dual-eligibles. The objective of our … prior to the date the new IB-Dual rate became effective. Key Findings DOH officials have made significant progress in … two were implemented and two were partially implemented. Key Recommendation DOH officials are requested, but not …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… (MCOs) a monthly premium for each enrolled recipient. In turn, the MCOs are required to pay for the services their … recipients have other third-party health insurance (TPHI) in addition to Medicaid (e.g., employer-based coverage or … provider reviews for the recovery of $52.2 million in inpatient claims where MCOs paid as the primary insurance …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsIFB #0001 – Disaster Recovery Services for the Printing, Sorting and Mailing of Payroll Checks and Tax Forms
… and mailing of payroll checks and tax forms as detailed in the solicitation available via the links below. The … through the following links: Invitation for Bids , in PDF Forms Only , in MS Word format Cost Proposa l, in MS Excel format … and mailing of payroll checks and tax forms as detailed in the solicitation available via the links below …
https://www.osc.ny.gov/procurement/ifb0001NYS Comptroller DiNapoli and Church of England Call on ExxonMobil to Set Targets for Lowering GHG Emissions
… on climate change. The ExxonMobil resolution comes just weeks after Shell and Climate Action 100+ signatory investors … pension fund in the United States with assets of $207.4 billion as of the March 31, 2018 end of its most recent …
https://www.osc.ny.gov/press/releases/2018/12/nys-comptroller-dinapoli-and-church-england-call-exxonmobil-set-targets-lowering-ghg-emissionsDiNapoli: 33.55 Percent Annual Investment Return for New York State Pension Fund Is Largest in Its History
… New York State Comptroller Thomas P. DiNapoli today announced that the New York State Common Retirement Fund’s (Fund) estimated overall investment return was 33.55 percent for the state fiscal year (SFY) that … State Comptroller DiNapoli announced that the New York State …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-33-point-55-percent-annual-investment-return-new-york-state-pension-fund-largest-its-historyUnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Follow-Up) (2023-F-14)
To determine the extent of implementation of the four recommendations included in our initial audit report, New York State Health Insurance Program – UnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Report 2020-S-7).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-23f14.pdfMedicaid Program: Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers (2023-S-18)
To determine whether the Department of Health (DOH) provided adequate oversight to ensure managed care recipients in the Recipient Restriction Program received services from the appropriate providers.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-23s18.pdfMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement (2022-S-40) 180-Day Response
To determine whether Medicaid inappropriately paid for drugs from manufacturers that did not enter into a national drug rebate agreement (NDRA).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2024-22s40-response.pdfMedicaid Program – Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (2022-S-16)(180-Day Response)
To determine whether Medicaid made improper payments to hospitals for outpatient services that were erroneously billed as inpatient claims.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22s16-response.pdfNew Yorkers in Need: A Look at Poverty Trends in New York State for the Last Decade
The COVID-19 pandemic had devastating health, economic and social consequences. In New York, the pandemic and ensuing economic shutdown produced almost 2 million job losses in 2020. Yet for many, economic hardships existed long before this time.
https://www.osc.ny.gov/files/reports/pdf/new-yorkers-in-need-poverty-trends.pdfImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up) (2021-F-4) 30-Day Response
To determine the extent of implementation of the three recommendations included in our initial audit report, Improper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Report 2018-S-65).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-21f4-response.pdfImproper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements (2019-S-2)
To determine whether the Department of Health paid for claims in violation of federal and State regulations that require an appropriate National Provider Identifier for ordering, prescribing, referring, and attending (OPRA) health care providers.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-19s2.pdf