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Monitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance
… disrepair or insolvency. When a not-for-profit cemetery is abandoned, either due to fiscal issues or simply because … and a Permanent Maintenance Fund, the principal of which is to be held in trust for future maintenance and … requirements. The Division’s monitoring and oversight is a critical means through which the State seeks to ensure …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/monitoring-not-profit-cemeteries-fiscal-stability-and-adequate-facility-maintenanceAdministration of Contract C007373 With the Institute for Community Living
… Purpose To determine whether the Office of Mental Health (OMH) is effectively administering its contract with the Institute for Community Living (ICL) by ensuring that contracted services were actually provided, … To determine whether the Office of Mental Health OMH is effectively administering …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-c007373-institute-community-livingAdministration of the Contract With the Postgraduate Center for Mental Health
… Housing Contract C007374 with the Postgraduate Center for Mental Health (PCMH) by ensuring that contracted services … contractors to operate many of these programs. PCMH, a not-for-profit entity, is one of New York’s largest providers of … all contract costs and serves as a cost claiming document for program reimbursement. At the end of each contract year, …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-postgraduate-center-mental-healthChildren’s Center for Early Learning – Compliance With the Reimbursable Cost Manual
To determine whether the expenses reported on the Consolidated Fiscal Reports CFRs of the Childrens Center for Early Learning Center were calculated proper
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/childrens-center-early-learning-compliance-reimbursable-cost-manualWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported on the Consolidated … properly, documented adequately, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost … provides a full-day preschool special education program to disabled children between the ages of three and five …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualMedicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… Purpose To determine the readiness of all Medicaid managed care organizations (MCOs) to submit Medicaid encounter transactions to the new … To determine the readiness of all Medicaid managed care organizations to submit Medicaid encounter transactions to the new …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background Our … was issued on December 9, 2010, examined whether nursing home claims submitted to Medicaid for hospital bed reserve … days were appropriate, and if not, to what extent nursing home claims exceeded the bed reserve day limits. During the …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… in our initial audit report, Excessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits … whether the Department was correctly paying claims for services to Medicaid recipients who also have health … and proactive steps to administer Medicaid reimbursements for services provided to dual eligible individuals. About …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followAstor Services for Children & Families – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Astor Services for Children & Families (Astor) on its Consolidated Fiscal … fiscal year ended June 30, 2013. Background Astor, a not-for-profit organization located in Rhinebeck, New York, … the ages of three and five years. Astor is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-compliance-reimbursable-cost-manualImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… State’s Medicaid program provides a wide range of health care services, including prescription drugs, to individuals … are economically disadvantaged and/or have special health care needs. The New York State Controlled Substances Act … allowed by the Act. We further identified 3,323 managed care claims for controlled substances in which the quantities …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followImproper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… included in our initial audit report, Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Report … which was issued on January 5, 2015, determined that, for the 27-month period October 1, 2011 through December 31, … our initial audit report Improper FeeforService Payments for Pharmacy Services …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followStarting Point Services for Children – Compliance With the Reimbursable Cost Manual
… Education Itinerant Teacher (SEIT) and Special Class Integrated Setting (SCIS) programs to disabled children … These ineligible costs included $2,228,711 in personal service costs and $356,743 in other than personal service costs. Among the disallowances we identified were: …
https://www.osc.ny.gov/state-agencies/audits/2015/12/11/starting-point-services-children-compliance-reimbursable-cost-manualUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… Interest New York State Health Insurance Program: United HealthCare - Certain Claim Payments for Evaluation and …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59Milestone School for Child Development – Compliance With the Reimbursable Cost Manual
… identified $801,859 in reported costs that did not comply with Manual requirements and recommend such costs be … to Milestone’s CFRs and reimbursement rates. Work with Milestone officials to help ensure their compliance with Manual provisions. To Milestone: Ensure that costs …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualAdministration of the Contract With the Center for Urban Community Services
… Purpose We audited the New York City Department of Health and Mental Hygiene’s … increased to $28.7 million for expanded program services. The New York State Office of Mental Health funds about 75 … We audited the New York City Department of Health and Mental Hygienes …
https://www.osc.ny.gov/state-agencies/audits/2016/02/16/administration-contract-center-urban-community-servicesMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… two separate payments are made: a payment for the first hospital’s claim and a payment for the second hospital’s claim. However, according to the Department’s … when a recipient is transferred from the first hospital to a merged or consolidated division or hospital, …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilitiesAll Services for Kids, Inc. – Compliance With the Reimbursable Cost Manual
… service expenses, including inappropriately allocated rental expenses, cell phones used by the Executive Director's minor children, unaccounted-for equipment items, and cable television. Key Recommendation SED …
https://www.osc.ny.gov/state-agencies/audits/2014/02/25/all-services-kids-inc-compliance-reimbursable-cost-manualMedicaid Program – Improper Payments of Medicare Buy-in Premiums for Ineligible Recipients
… Medicare premium payments on behalf of recipients enrolled in the Medicare buy-in program. The audit covered Medicaid payments for individuals enrolled in the Medicare buy-in program for the period from January 1, … Medicare premium payments on behalf of recipients enrolled in the Medicare buyin program …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-payments-medicare-buy-premiums-ineligible-recipientsOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… Objective To assess the extent of implementation of the three … Medicaid program provides a wide range of medical services to those who are economically disadvantaged and/or have … also enrolled in Medicare. Such individuals are referred to as “dual-eligibles.” The Medicare program covers physical, …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… To determine whether Empire BlueCross properly paid hospital claims for intraocular procedures. The audit covered … million members. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitals