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Quality Services for the Autism Community - Compliance With the Reimbursable Cost Manual (2018-S-8) 180-Day Response
To determine whether the costs reported by Quality Services for the Autism Community on its Consolidated Fiscal Report were reasonable, necessary ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-18s8-response.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.pdfNorthside Center for Child Development - Compliance With the Reimbursable Cost Manual (2017-S-15) 90-Day Response
To determine whether the costs reported by Northside Center for Child Development on its Consolidated Fiscal Report were reasonable, necessary...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s15-response.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.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: 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.pdfManaged Care Premium Payments for Recipients With Comprehensive Third-Party Insurance (Follow-Up) (2019-F-33) 30-Day Response
To determine the extent of implementation of the seven recommendations made in our initial audit report, Managed Care Premium Payments for Recipients With...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19f33-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.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.pdfAdministration of Contract C007373 With the Institute for Community Living (2015-S-39), 90-Day Response
To determine whether the Office of Mental Health (OMH) is effectively administering its contract with the Institute for Community Living (ICL) by ensuring that
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2017-15s39-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.pdfYork College - Time and Attendance Practices for Public Safety Staff (Follow-Up) (2018-F-29) 30-Day Response
To determine the extent of implementation of the seven recommendations included in our initial audit report, Time and Attendance Practices for Public Safety...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18f29-response.pdfMedicaid 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.pdf