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Overpayments for Services Also Covered by Medicare Part B (Follow-Up)
… report, Overpayments for Services Also Covered by Medicare Part B (Report 2012-S-27). Background Many of the State’s Medicaid recipients are also enrolled in Medicare Part B, which provides supplementary medical insurance for a … enhanced reimbursements from Medicaid and Medicare for the Part B services they provide. FQHCs are “safety net” …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followContracts for Personal and Miscellaneous Services (Follow-Up)
… often not prepared. In addition, the MTA did not have a requirement to periodically assess whether existing personal … to help reduce costs. We also found that there was no requirement that the operating unit requesting the services …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/contracts-personal-and-miscellaneous-services-followImproper Payments Related to the Medicare Buy-In Program (Follow-Up)
… the extent of implementation of the five recommendations made in our audit report, Improper Payments Related to the … Our initial audit report, which was issued on October 26, 2012, determined that, from March 2006 through February … not implemented. Key Recommendation Officials are given 30 days after the issuance of the follow-up report to provide …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/improper-payments-related-medicare-buy-program-followSafety of Infrastructure (Follow-Up)
… Purpose To determine the extent of implementation of the two recommendations included in our original report, Safety … one problem area discussed in our prior audit. Of the two prior audit recommendations, one was implemented and one … To determine the extent of implementation of the two recommendations included in our original report Safety of …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/safety-infrastructure-followMedicaid Payments for Excessive Dental Services (Follow-Up)
… of implementation of the six recommendations included in our initial audit report, Medicaid Payments for Excessive Dental Services (Report 2009-S-46). Background Our initial … by these payments may be legitimate services provided in good faith, other dental services appeared highly …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/medicaid-payments-excessive-dental-services-followRebates and Discounts on Physician-Administered Drugs (Follow-Up)
… Drug Pricing Program, which requires drug manufacturers to discount, at the time of sale, the price of drugs sold to …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/rebates-and-discounts-physician-administered-drugs-followAmerican Academy of Pediatrics, District II
… Purpose In conjunction with our Investigations Unit, we examined select payments the Department of Health (Department) made to the American Academy of Pediatrics, District II (AAP) … In conjunction with our Investigations Unit we examined select payments the Department of Health Department made to the American …
https://www.osc.ny.gov/state-agencies/audits/2014/02/28/american-academy-pediatrics-district-iiSelected Employee Travel Expenses
… by selected government employees complied with rules and regulations and is free from fraud, waste and abuse. The audit covers the period April 1, 2008 to March … by selected government employees complied with rules and regulations and is free from fraud waste and abuse …
https://www.osc.ny.gov/state-agencies/audits/2013/09/04/selected-employee-travel-expensesUnder Reporting of Net Available Monthly Income for Nursing Home Residents Causes Medicaid Overpayments (Follow-Up)
… of Net Available Monthly Income for Nursing Home Residents Causes Medicaid Overpayments (Report 2010-S-17). Background … of Net Available Monthly Income for Nursing Home Residents Causes Medicaid Overpayments (2010-S-17) …
https://www.osc.ny.gov/state-agencies/audits/2013/08/16/under-reporting-net-available-monthly-income-nursing-home-residents-causes-medicaidEducators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … Educators for Children, Youth and Families, Inc. - Use of Contract Funds (Report 2007-S-128). Background Our initial … Determine the extent of implementation of the 3 recs included in our initial audit …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/educators-children-youth-and-families-inc-use-contract-funds-followNew York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… our initial audit report, Payments by Empire BlueCross for Hospital Services for Ineligible Members (Report 2019-S-32 ). … Empire BlueCross (Empire) to administer the Empire Plan’s hospital benefits. Civil Service maintains the New York … August 18, 2020, sought to determine whether Empire paid hospital claims for members who were not eligible for …
https://www.osc.ny.gov/state-agencies/audits/2021/12/27/new-york-state-health-insurance-program-payments-empire-bluecross-hospital-servicesOversight of Construction Management Contracts (Follow-Up)
… historic, cultural, and recreational resources of New York State. This system includes over 250 parks, historic … a contract with the Dormitory Authority of the State of New York (DASNY) to serve as the construction manager of a …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/oversight-construction-management-contracts-followCompliance With Executive Order 95 (Open Data)
… and maintaining facilities developed for the 1980 Winter Olympics, Gore Mountain, and Belleayre Mountain. As of August …
https://www.osc.ny.gov/state-agencies/audits/2021/02/08/compliance-executive-order-95-open-dataAllocation, Billing, and Collection of Expenses of Administering the Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act (Follow-Up)
… or whose property they might damage as a result of an accident. Department activities relating to the Acts fall … the Compulsory Insurance Services Program, and the Accident Prevention Course Program. Under the Acts, the …
https://www.osc.ny.gov/state-agencies/audits/2021/05/27/allocation-billing-and-collection-expenses-administering-motor-vehicle-financial-securityUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Follow-Up)
… of implementation of the two recommendations included in our initial audit report, Out-of-Network Providers … improvements. Key Finding United officials made progress in addressing the problems we identified in the initial audit. In particular, United saved the Empire …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesOversight of Nurse Hiring and Retention (Follow-Up)
… of implementation of the four recommendations included in our initial audit report, Oversight of Nurse Hiring and … the provision and delivery of comprehensive health care in New York City’s public hospitals and clinics. As the largest public health care system in the nation, Health and Hospitals provides essential …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/oversight-nurse-hiring-and-retention-followMedicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY (Follow-Up)
To determine the extent of implementation of the five recommendations included in our initial audit report Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY Report 2017S36
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-part-b-services-billed-directly-emedny-followMedicaid Overpayments for Medicare Advantage Plan Services (Follow-Up)
… of implementation of the five recommendations included in our initial audit report, Medicaid Overpayments for … program. Many Medicaid recipients are also enrolled in Medicare Part C, commonly referred to as Medicare Managed … overpayments occurred because adequate controls were not in place to detect the improper claims. We recommended the …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followImproper Medicaid Payments for Misclassified Patient Discharges (Follow-Up)
… reported discharge (which often meets the definition of a transfer). Key Findings Officials have made some progress in …
https://www.osc.ny.gov/state-agencies/audits/2023/01/18/improper-medicaid-payments-misclassified-patient-discharges-followNew York State Health Insurance Program – Payments by CVS Health for Pharmacy Services for Ineligible Members (Follow-Up)
… Members (Report 2020-S-17 ). About the Program The New York State Health Insurance Program (NYSHIP), … Plan’s pharmacy benefits. Civil Service maintains the New York Benefits Eligibility and Accounting System (NYBEAS), …
https://www.osc.ny.gov/state-agencies/audits/2023/01/04/new-york-state-health-insurance-program-payments-cvs-health-pharmacy-services-ineligible