Search
Improper Managed Care Premium Payments for Recipients With Duplicate Client Identification Numbers (Follow-Up)
… included in our initial audit report, Improper Managed Care Premium Payments for Recipients With Duplicate Client … was to determine whether improper Medicaid managed care premiums were paid on behalf of recipients with … audit identified over $102.1 million in improper managed care premium payments on behalf of 65,961 recipients with …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/improper-managed-care-premium-payments-recipients-duplicate-client-identification-numbersCompliance With Payment Card Industry Standards
… Purpose To determine whether the Thruway Authority (Authority) complies with Payment Card … measures associated with credit card data – intended to help an organization proactively protect customer credit … To determine whether the Thruway Authority complies with …
https://www.osc.ny.gov/state-agencies/audits/2017/09/19/compliance-payment-card-industry-standardsHealth Information Management Department – Selected Procurement and Human Resources Practices
… is Long Island’s premier academic and regional medical center and, with 603 beds, the region’s only tertiary-care center and level 1 trauma center. As part of Stony Brook … excellence in patient care, education, research, and community service. In fulfilling its mission, the Hospital is …
https://www.osc.ny.gov/state-agencies/audits/2014/09/16/health-information-management-department-selected-procurement-and-human-resources-practicesNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… Program - Payments for Scaling and Root Planing Procedure s (Report 2009-S-95). Background Our initial audit report, which was issued … gum line. Root planing involves a smoothing of the rough spots on root surfaces. Scaling and root planing are covered …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… portion of the Plan. Empire processes and pays claims for hospital services in accordance with agreements Empire negotiates with member hospitals. Payments for hospital services are generally based on standard fee … to provide information on any actions that are planned to address the unresolved issues discussed in this report. Other …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughSelected Employee Travel Expenses
… and under the control of agency management, include car rentals, meals, lodging, transportation, fuel, and … We selected these employees based primarily on high rental car expenses. One employee was selected because of … costs for two of the three employees' long-term use of rental vehicles for job-related travel. We concluded that …
https://www.osc.ny.gov/state-agencies/audits/2014/05/22/selected-employee-travel-expensesAffordable Home Ownership Development Program
… Program criteria. Our audit covers the period February 2012 through October 2013, and focuses on grants awarded to …
https://www.osc.ny.gov/state-agencies/audits/2014/10/06/affordable-home-ownership-development-programOverpayments of Certain Medicare Crossover Claims
… Purpose To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify the claims processing control weaknesses that … To determine if Medicaid overpaid Medicare crossover claims …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsBrighter Choice Charter Middle School for Boys – Financial Operations (2013M-348)
… audit was to evaluate the effectiveness of the School’s compact contract with the Foundation for the period July 1, … Boys is located in the City of Albany, and is governed by a Board of Trustees, which is currently comprised of seven … $2.71 million. Key Findings The School entered into a three-year compact agreement with the Foundation in June …
https://www.osc.ny.gov/local-government/audits/school-district/2014/02/07/brighter-choice-charter-middle-school-boys-financial-operations-2013m-348City of Yonkers – Budget Review (B22-6-6)
… and the related justification documents are in compliance with the requirements of the Fiscal Agent Act (Chapter 488 of …
https://www.osc.ny.gov/local-government/audits/city/2022/06/10/city-yonkers-budget-review-b22-6-6Selected Aspects of Parking Violations Operations to Collect Fines and Fees
… its Summons Tracking and Accounts Receivable System (STARS) to accomplish these tasks. Key Findings Overall, we … issued before November 1, 2002. Key Recommendations Ensure STARS properly accounts for all the summonses that have been …
https://www.osc.ny.gov/state-agencies/audits/2019/12/04/selected-aspects-parking-violations-operations-collect-fines-and-feesCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… included in our initial audit report, Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service … with drug manufacturers for rebates and remit the rebate revenue to Civil Service. Our initial audit report, … sought to determine if CVS Health remitted commercial drug rebate revenue related to Empire Plan drug utilization in …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up)
… the services that plans must cover and pay for (benefit packages) in exchange for monthly premium payments for each … covered services. We issued our initial audit report on January 17, 2020. The audit objective was to determine … by MLTC plans. The audit covered the period from January 1, 2014 through June 30, 2019. Our audit identified $16.4 …
https://www.osc.ny.gov/state-agencies/audits/2021/08/31/improper-fee-service-payments-services-covered-managed-long-term-care-plans-followMedicaid Program – Cost of Pharmacy Services Under Managed Care
… Objective To determine whether the Department of Health (Department) obtained Medicaid pharmacy services under managed care in an economical manner. The audit covered the period January … To determine whether the Department of Health Department obtained Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/09/17/medicaid-program-cost-pharmacy-services-under-managed-careMedicaid Program – Accuracy of Medicaid Eligibility Determined by NY State of Health
… timely Medicaid eligibility and enrollment information to the Medicaid claims payment system, and if it did not, determine the corresponding Medicaid overpayments. The audit covered the period January 1, 2014 through February … timely Medicaid eligibility and enrollment information to the Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/09/17/medicaid-program-accuracy-medicaid-eligibility-determined-ny-state-healthNew York State Health Insurance Program – Empire Plan Members With Dual Family Coverage (Follow-Up)
… York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), covers …
https://www.osc.ny.gov/state-agencies/audits/2022/09/26/new-york-state-health-insurance-program-empire-plan-members-dual-family-coverage-followAccuracy of Medicaid Eligibility Determined by NY State of Health (Follow-Up)
… Objective To determine the extent of implementation of the six recommendations included in our initial audit report, Accuracy of Medicaid Eligibility Determined by NY State of Health … To determine the extent of implementation of the six recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2022/09/30/accuracy-medicaid-eligibility-determined-ny-state-health-followImproper Medicaid Payments for Terminated Drugs (Follow-Up)
… programs to reject these claims on the basis of the drug’s termination date (defined as either the expiration … date of the final batch produced or the date the drug was recalled for health and safety reasons). Pursuant to CMS guidelines, the Department maintains drug termination dates in eMedNY, its claims processing and …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/improper-medicaid-payments-terminated-drugs-followWyoming County Court and Trust Funds (2020-C&T-2)
… [read complete report - pdf] Purpose of Review The purpose of our review was to determine whether County … to safeguard and account for court and trust funds for the period January 1, 2017 through March 11, 2020. Background … The purpose of our review was to determine whether County …
https://www.osc.ny.gov/local-government/audits/court-and-trust/2020/05/08/wyoming-county-court-and-trust-funds-2020-ct-2Firemen’s Benevolent Association of the Village of Le Roy – Oversight of the Association’s Foreign Fire Insurance Tax Moneys (2014M-026)
… Association’s receipt and disbursement of the Foreign Fire Insurance tax for the period January 1, 2012 through December … and is funded almost exclusively from the foreign fire insurance (FFI) tax, which totaled $12,332 in the 2013 fiscal … of Le Roy Oversight of the Associations Foreign Fire Insurance Tax Moneys 2014M026 …
https://www.osc.ny.gov/local-government/audits/fire-district/2014/10/06/firemens-benevolent-association-village-le-roy-oversight-associations