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Medicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities (2014-S-18), 90-Day Response
To determine whether the Department established adequate controls over inpatient claims for recipients who were transferred between merged or consolidated
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2014-14s18-response.pdfOutdated Municipal Structures Cities, Towns and Villages – 18th Century Designations for 21st Century Communities
Outdated Municipal Structures Cities, Towns and Villages – 18th Century Designations for 21st Century Communities
https://www.osc.ny.gov/files/local-government/publications/pdf/munistructures.pdfMedicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (Follow-Up) (2018-F-26) 90-Day Response
To determine the extent of implementation of the four recommendations made in our initial audit report, Medicaid Payments for Pharmacy Claims – Joia Pharmacy...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18f26-response.pdfAccounting for Medicaid Reimbursements Paid by the Department of Health and the Resulting State Aid Deduction
Accounting for Medicaid Reimbursements Paid by the Department of Health and the Resulting State Aid Deduction
https://www.osc.ny.gov/files/local-government/publications/pdf/MedicaidReimbursements0414.pdfInterdisciplinary Center for Child Development - Compliance With the Reimbursable Cost Manual (2017-S-31) 90-Day Response
To determine whether the costs reported by the Interdisciplinary Center for Child Development on its Consolidated Fiscal Reports (CFRs) were reasonable ...
https://www.osc.ny.gov/files/local-government/audits/pdf/sga-2018-17s31-response.pdfUnitedHealthcare 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.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.pdfAccounting and Financial Reporting for Pensions as Required by GASB 68 and Updated by GASB 82
The purpose of this bulletin is to provide updated information regarding pension accounting treatment and guidance.
https://www.osc.ny.gov/files/local-government/publications/pdf/bulletin-gasb-68-reporting-pensions.pdfEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals (2019-S-31) 180-Day Response
To determine whether Empire BlueCross properly paid hospital claims for intraocular procedures. The audit covered the period January 1, 2014 through June 30...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s31-response.pdfAccounting and Financial Reporting for Pensions as Required by GASB 68 and Updated by GASB 82
The purpose of this bulletin is to provide updated information regarding pension accounting treatment and guidance.
https://www.osc.ny.gov/files/local-government/publications/pdf/gasb-68-reporting-for-pensions-0320.pdfAudit of the Tuition Reimbursement Account for the Five Fiscal Years Ended March 31, 2018 (2019-S-3)
To express an opinion on the fair presentation of the Financial Statements of the Tuition Reimbursement Account for the five fiscal years ended March 31, 2018.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-19s3.pdfMedicaid Program - Improper Fee-for-Service Payments for Services Covered by Managed Care (2017-S-74) 90-Day Response
To determine whether Medicaid made improper fee-for-service (FFS) payments for certain services covered by mainstream managed care plans.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s74-response.pdfUnitedHealthcare: Improper Payments for Medical Services Designated By Modifier Code 59 (2013-S-82), 90-Day Response
To determine whether UnitedHealthcare improperly paid for medical services designated with modifier code 59 that were not distinct and independent from other se
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s82-response.pdfMedicaid Program - Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (2013-S-57)
To determine if Medicaid overpaid managed care organizations and hospitals for low birth weight newborn claims.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s57.pdfMedicaid Program - Excessive Medicaid Payments to Federally Qualified Health Centers for Group Therapy Services (2013-S-51)
To determine if Medicaid reimbursement rates for group therapy services provided by Federally Qualified Health Centers were correctly applied
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s51.pdfMedicaid Program - Questionable Payments for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician (2012-S-35)
To determine if Dr. Riaz Ahmad complied with Medicaid policies and whether Dr. Ahmad’s medical records support the services he billed and the prescriptions he
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-12s35.pdfChildren’s Center for Early Learning - Compliance With the Reimbursable Cost Manual (2011-S-21), 90-Day Response
To determine whether the expenses reported on the Consolidated Fiscal Reports (CFRs) of the Children’s Center for Early Learning (Center) were calculated proper
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-11s21-response.pdfMedicaid Program - Medicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (2013-S-4), 90-Day Response
To determine whether Medicaid made proper payments to Joia Pharmacy, Inc. (Joia) and a related prescriber (herein referred to as “the Doctor”) in compliance wit
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2017-13s4-response.pdfUnited HealthCare: Overpayments for Services Provided by Hudson Valley Bone and Joint Surgeons, LLP (2016-S-17)
To determine whether Hudson Valley Bone and Joint Surgeons, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2016-16s17.pdfMedicaid Program - Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (2017-S-85) 90-Day Response
To determine whether Medicaid made overpayments to hospitals that improperly billed All Patient Refined Diagnosis Related Groups inpatient claims ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s85-response.pdf