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Oversight of Persons Convicted of Driving While Intoxicated
… the period August 15, 2010 to May 19, 2015. Background In New York, Driving While Intoxicated (DWI) is a serious … 15, 2010 must install an Ignition Interlock Device (IID) in any vehicle they own or operate. In addition, the Department of Motor Vehicles (DMV) adds an …
https://www.osc.ny.gov/state-agencies/audits/2015/10/07/oversight-persons-convicted-driving-while-intoxicatedMedicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… through March 31, 2010. Background Medicaid recipients in need of inpatient hospital care are provided a full range … primarily because hospitals billed Medicaid for days in acute care settings when, in fact, patients received lower cost ALC. In one case, …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissionsDual Employment
… multiple facilities. Employees may also work for other government agencies subject to certain restrictions and … approval requirements established in law and civil service regulation. Key Findings Between April 2010 and March 2012, … than one DOCCS facility or a DOCCS facility and another government agency, earning over $20,000 from each job. We …
https://www.osc.ny.gov/state-agencies/audits/2013/12/19/dual-employment-2Medicaid Program – Oversight of Localities' Efforts to Coordinate Veterans' Health Care Benefits Under Medicaid and the U.S. Department of Veterans Affairs
… to more than 70,000 veterans. Many veterans enrolled in Medicaid are also entitled to health care benefits through … that referrals to the State DVA/local VSA were not made in 81 of 91 (89 percent) of the cases tested. Further, local … and dependents eligible for VA health care benefits. In accordance with the Affordable Care Act, the Department …
https://www.osc.ny.gov/state-agencies/audits/2014/03/19/medicaid-program-oversight-localities-efforts-coordinate-veterans-health-care-benefitsMedicaid Program – Errors in Identification of 340B Providers in the Medicaid Drug Rebate Program
… Purpose To determine whether the Department of Health (Department) accurately excluded 340B drugs from … To collect rebates, states determine the amount of rebates owed to them and send invoices to the … program requires drug manufacturers to discount the price of drugs sold to eligible health care providers. The Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2017/06/30/medicaid-program-errors-identification-340b-providers-medicaid-drug-rebate-programCriminal History Background Checks of Unlicensed Health Care Employees
… history background checks when hiring unlicensed persons in direct care positions. Our audit covered the period of … criminal history background checks of unlicensed persons in Nursing Homes, ACFs, and HHCs. Providers submit an … through the CHRC system to the Department. The Department, in turn, submits a fingerprint request on behalf of the …
https://www.osc.ny.gov/state-agencies/audits/2017/06/08/criminal-history-background-checks-unlicensed-health-care-employeesFacility Planning Bureau Project Review (Follow-Up)
To determine the extent of implementation of the three recommendations included in our initial audit report Facility Planning Bureau Project Review 2018S2
https://www.osc.ny.gov/state-agencies/audits/2022/01/05/facility-planning-bureau-project-review-followMedicaid Program – Improper Payments for Services Related to Ordering, Prescribing, Referring, or Attending Providers No Longer Participating in the Medicaid Program
… inactive OPRA providers and determine an appropriate course of action. Enhance controls to prevent improper …
https://www.osc.ny.gov/state-agencies/audits/2022/04/19/medicaid-program-improper-payments-services-related-ordering-prescribing-referring-orPayments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members
… eligibility and enrollment records for NYSHIP members in the New York Benefits Eligibility and Accounting System … System (CAS). Typically, organizations that participate in NYSHIP (e.g., State agencies, local government employers, … eligibility transactions, such as disenrollments, in NYBEAS. Accurate, up-to-date enrollment information in …
https://www.osc.ny.gov/state-agencies/audits/2022/05/13/payments-beacon-health-options-mental-health-and-substance-abuse-services-ineligibleSelected Wage Investigation Procedures
… assist the unemployed, and connect job seekers to jobs. In fulfilling these responsibilities, the Department’s … The Division can require employers found to be in violation of the Laws to pay restitution of wages and can … liquidated damages, which are additional amounts assessed in an effort to compensate workers for the delay in receiving …
https://www.osc.ny.gov/state-agencies/audits/2021/03/03/selected-wage-investigation-proceduresHousing Trust Fund Corporation – Oversight of the Residential Emergency Services to Offer Home Repairs to the Elderly Program
… to Offer Home Repairs to the Elderly (RESTORE) program in accordance with program goals and requirements. The audit covered awards in funding years 2017-19. About the Program HCR consists of … prescribed time frames to better support senior homeowners in need of assistance. Specifically, we found: Inaccurate …
https://www.osc.ny.gov/state-agencies/audits/2021/07/15/housing-trust-fund-corporation-oversight-residential-emergency-services-offer-home-repairsMedicaid Program – Cost Saving Opportunities on Payments of Medicare Part C Claims
… whether Medicaid cost savings can be achieved by modifying the reimbursement methodology for Medicare Part C cost-sharing claims in accordance with federal requirements. The audit covered the period from July 1, 2016 through … whether Medicaid cost savings can be achieved by modifying the reimbursement methodology for Medicare Part C costsharing …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-cost-saving-opportunities-payments-medicare-part-c-claimsCompliance With Freedom of Information Law Requirements
… its subsidiaries have policies, procedures, and processes in place to fulfill CDTA’s responsibilities under the Freedom … of Information Law (FOIL), and to determine if CDTA is in compliance with its responsibilities under FOIL. The audit … January 23, 2020. About the Program CDTA was created in 1970 by the New York State Legislature. Today, CDTA is the …
https://www.osc.ny.gov/state-agencies/audits/2020/10/16/compliance-freedom-information-law-requirementsNew York City Department of Homeless Services – Oversight of Contract Expenditures of Samaritan Daytop Village, Inc.
… the fiscal years ended June 30, 2020 and June 30, 2021. In addition, we reviewed limited aspects of DHS’ claim … services for eligible homeless families and individuals in New York City (City) and for providing fiscal oversight of the homeless shelters. In July 2013, DHS contracted with Samaritan, a City-based …
https://www.osc.ny.gov/state-agencies/audits/2024/02/06/new-york-city-department-homeless-services-oversight-contract-expenditures-samaritan-daytopLicensing and Monitoring of Proprietary Schools (Follow-Up)
… York State. When initially granted, a proprietary school’s license is valid for 2 years. Thereafter, license renewals … in violation of the Law or Regulations may be placed on probation; have their license suspended, revoked, or not … after the issuance of this report to provide information on any actions that are planned to address the unresolved …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/licensing-and-monitoring-proprietary-schools-followMedicaid 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-recipientsUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services
… health benefits plan for NYSHIP, covering a comprehensive range of services for about 1.1 million of these members. The … program. Medical/surgical benefits cover a range of services such as office visits, outpatient surgery, …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesDevelopmental Disabilities Institute, Inc. – Compliance With the Reimbursable Cost Manual
… Special Classes and half-day and full-day Special Classes in an Integrated Setting. For the purposes of this report, … provided by these programs are based on fixed fees. In addition, DDI operated an SED-approved school-age special … DDI served about 577 preschool special education students in its cost-based programs. Local counties refer students to …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/developmental-disabilities-institute-inc-compliance-reimbursable-cost-manualLeague Treatment Center – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by League Treatment Center (LTC) on its … (CFR) were reasonable, necessary, directly related to the special education programs, and sufficiently documented pursuant to the State Education Department’s (SED) Reimbursable Cost …
https://www.osc.ny.gov/state-agencies/audits/2019/12/16/league-treatment-center-compliance-reimbursable-cost-manualState Agencies Bulletin No. 1937
… Affected Employees Employees who are overtime eligible and in the Public Employees Federation (PEF)-BU05 are affected. … Public Employees Federation (PEF), provides for a change in the calculation of overtime. Prior to the 2019-2023 … hours. The new agreement changes the overtime factor used in the calculation of overtime. Overtime earned on or after …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1937-new-overtime-earnings-codes-overtime-eligible-employees-public