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Medicaid Program – Managed Care Organizations: Payments to Ineligible Providers
… The Department administers New York’s Medicaid program. For the State fiscal year ended March 31, 2017, New York’s … totaled over $58 billion, of which managed care accounted for about $34 billion. Under managed care, Medicaid pays MCOs a monthly premium for each enrolled Medicaid recipient, and the MCOs arrange …
https://www.osc.ny.gov/state-agencies/audits/2018/02/26/medicaid-program-managed-care-organizations-payments-ineligible-providersSeized Assets Program (Follow-Up)
… Purpose To determine the extent of implementation of the six recommendations included in our original report, … of the New York State Division of State Police (Division) is to serve, protect, and defend the people of New York State …
https://www.osc.ny.gov/state-agencies/audits/2017/11/28/seized-assets-program-followForensic Audit of Select Payroll and Overtime Practices and Related Transactions (Follow-Up)
… of implementation of the six recommendations included in our initial report, Forensic Audit of Select Payroll and … related to Hours of Service that may have been avoidable. For calendar 2010, we determined that these practices cost … these payments will inflate future pension payments for these employees by about $5.5 million. We also found …
https://www.osc.ny.gov/state-agencies/audits/2016/03/18/forensic-audit-select-payroll-and-overtime-practices-and-related-transactions-followBus Driver Licensing (Follow-Up)
… Purpose To determine the extent of implementation of the four recommendations included in our initial report, Bus … initial report, issued on June 13, 2013, determined that the majority of MTA bus drivers we sampled met the …
https://www.osc.ny.gov/state-agencies/audits/2016/01/21/bus-driver-licensing-followBenefit Eligibility Assessment Process (Follow-Up)
… Fair Hearings. These hearings were unnecessary because the case had either already been resolved to the client’s … satisfaction, or HRA could not proceed due to missing case file support or erroneously prepared documents. We also found that OTDA’s closed-case coding system did not always adequately describe the …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/benefit-eligibility-assessment-process-followAccess-A-Ride Accident Claims (Follow-Up)
… by traditional carriers decreased and reliance on the black car services and taxis increased. The number of … there was an unquantified liability risk associated with black car services and taxis that was expanding and was not …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/access-ride-accident-claims-followUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… in our initial audit report, United HealthCare - Payments for Fraudulent and Improper Claims Submitted by Davis Ethical … which was issued on August 13, 2013, determined that, for the period January 1, 2008 through December 13, 2011, the … fraudulent claims to NYSHIP and received payments for those claims. We coordinated our audit and investigative …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacySuspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists (Follow-Up)
… through June 8, 2011, Medicaid paid about $6.9 million for services purportedly performed by the six dentists at the … also found that the dentists routinely certified claims for services that were purportedly provided by another … our findings to the State Attorney General’s Office for further investigation. In August 2012, Lawrence Bruckner …
https://www.osc.ny.gov/state-agencies/audits/2015/12/30/suspicious-and-fraudulent-medicaid-payments-affiliated-brooklyn-dentists-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Follow-Up)
… Program: Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Report … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The New York State Department of Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughAssessment of Costs to Administer the Workers’ Compensation Program for the Two Fiscal Years Ended March 31, 2013
… and nonoccupational disabilities and sickness. Coverage for these benefits, with limited exception, is to be provided by employers. The Board is also responsible for tracking its costs to administer the Workers’ … lacks a formal review process to ensure the procedures for preparing the assessment are properly executed and …
https://www.osc.ny.gov/state-agencies/audits/2015/04/15/assessment-costs-administer-workers-compensation-program-two-fiscal-years-ended-march-31Unified Court System Bulletin No. UCS-95
… the Unified Court System of the change in eligibility for payroll Deduction Code 300, MetLife Whole Life Insurance. … the Unified Court System of the change in eligibility for payroll Deduction Code 300 MetLife Whole Life Insurance …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-95-change-eligibility-metlife-whole-life-insurance-certainOutstanding Violations (Follow-Up)
… As a result, some Class 1 violations remained open for as long as six months before the Department followed up …
https://www.osc.ny.gov/state-agencies/audits/2014/10/15/outstanding-violations-followOpinion 98-5
… -- Interest in Contract (county coroner paid by county for burial of public assistance recipients) COUNTY CORONER -- Conflicts of Interest (payment by county for burial of public assistance recipients) GENERAL MUNICIPAL … a bill to the county department of social services for payment of the costs of burying a deceased public …
https://www.osc.ny.gov/legal-opinions/opinion-98-5Opinion 2001-2
… be credited with twenty-five points); (granting of points for one activity conditioned upon accumulation of points in … greater than the statutory minimum in order to qualify for the twenty-five points for that activity; and (3) A program sponsor may not create …
https://www.osc.ny.gov/legal-opinions/opinion-2001-2Opinion 2001-4
… the opinion. TOWN ASSESSOR -- Compensation (fixed amount for specified services plus hourly rate for revaluation work to be performed by appointive assessor); (salary increase for appointive assessor) LOCAL LAWS -- … amount plus hourly rate for appointive town assessor); (salary increase for appointive town assessor) TOWN LAW …
https://www.osc.ny.gov/legal-opinions/opinion-2001-4Opinion 2000-7
… the governing board or body is elected and serves without salary (see, e.g., Town Law §174[2], [3]); (2) the …
https://www.osc.ny.gov/legal-opinions/opinion-2000-7State Agency Small-Dollar Purchases (Follow-Up)
… in its efforts to increase State agencies’ P-Card use for small-dollar purchases. Aggregate P-Card use increased … have P-Cards during either year, and one used the P-Card for all purchases during both years. Key Recommendations None …
https://www.osc.ny.gov/state-agencies/audits/2013/11/21/state-agency-small-dollar-purchases-followProcurement and Contracting Practices (Follow-Up)
… (ITS), formerly known as the New York State Office for Technology, resulted in the best value for taxpayers, consistent with applicable legal, regulatory … policies. This did not result in the best value for the taxpayers, but instead led to a waste of substantial …
https://www.osc.ny.gov/state-agencies/audits/2014/04/16/procurement-and-contracting-practices-followSafety of Infrastructure (Follow-Up)
… infrastructure problems are likely to remain unaddressed for an extended period of time. Key Findings We found Parks … comprehensive, up-to-date listing of backlogged projects. For fiscal years 2012-13 and 2013-14, Parks started or …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/safety-infrastructure-followManagement of Energy Consumption (Follow-Up)
… energy consumption. OCFS now retains energy usage data for all OCFS facilities so reduction achievements can be …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/management-energy-consumption-follow