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Empire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… extent of implementation of the three recommendations made in our audit report, New York State Health Insurance Program: … processes and pays Plan claims for hospital services in accordance with agreements Empire negotiates with member … Key Finding Empire officials made considerable progress in implementing the recommendations we made in our initial …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Follow-Up)
… extent of implementation of the three recommendations made in our audit report, New York State Health Insurance Program: … processes and pays Plan claims for hospital services in accordance with agreements Empire negotiates with member … Key Finding Empire officials made considerable progress in implementing the recommendations we made in our initial …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughEmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits
… whether EmblemHealth Plan, Inc. overpaid dental claims for members covered by two subscriber plans under the New … EmblemHealth Plan, Inc. (Emblem) to process and pay claims for services on behalf of the New York State Dental Insurance … benefits (COB) is a process health insurance companies use for paying health care claims when an individual is covered …
https://www.osc.ny.gov/state-agencies/audits/2024/01/08/emblemhealth-plan-inc-overpayments-services-requiring-coordination-benefitsOversight of Mental Health Education in Schools (Follow-Up)
… Objective To determine the extent of implementation of the two recommendations included in our initial audit report, Oversight of Mental Health Education in Schools (Report 2020-S-63 ). …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/oversight-mental-health-education-schools-followMedicaid Program – Oversight of Managed Long-Term Care Member Eligibility
… in MLTC plans, which provide long-term care services, such as home health care and nursing home care, for people … responsible for initiating disenrollment of enrollees when it is determined they are no longer MLTC eligible (e.g., …
https://www.osc.ny.gov/state-agencies/audits/2022/08/05/medicaid-program-oversight-managed-long-term-care-member-eligibilityDiNapoli Releases Bond Calendar for First Quarter
… of which is for new money purposes. The anticipated sales in the first quarter compare to past planned sales of $5.05 … is released by the committee to assist participants in the municipal bond market. It is contingent upon execution …
https://www.osc.ny.gov/press/releases/2022/01/dinapoli-releases-bond-calendar-first-quarterDiNapoli: Former Bemus Point Clerk Arrested for Theft of Over $60,000
… Sheriff James B. Quattrone today announced the arrest of Jennifer Jaeger, former Bemus Point village clerk, for the alleged theft of more than $60,000 in village funds. Jaeger, 38, of Bemus Point, allegedly wrote village checks to herself …
https://www.osc.ny.gov/press/releases/2021/02/dinapoli-former-bemus-point-clerk-arrested-theft-over-60000Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… (OMIG), and it recovered about $7.4 million from the Plans by the end of the audit. We also found the New York City … are given 30 days after the issuance of the follow-up report to provide information on any actions that are … to address the unresolved issues discussed in the follow-up report. … To determine the extent of implementation of the …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andDiNapoli Releases Bond Calendar for Fourth Quarter
… the month of December at this time. The anticipated sales in the fourth quarter compare to past planned sales of $6.75 … is released by the committee to assist participants in the municipal bond market. It is contingent upon execution …
https://www.osc.ny.gov/press/releases/2021/10/dinapoli-releases-bond-calendar-fourth-quarterImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… made in our initial audit report, Improper Medicaid Payments for Recipients in Hospice Care ( 2017-S-76 ). About the Program Hospice is a program that provides care to … to identify recipients receiving hospice care; determine what services are disallowed in conjunction with hospice …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followPublic Officers – Membership and Enrollment
… Public Officer’s Law requires every public officer to take and file an oath or affirmation prior to the discharge of any … term. Any public officer who is re-appointed should take and file an oath or affirmation at the beginning of each new … planning boards, Town or Village Justice, County Attorney and District Attorney. Other positions that may be considered …
https://www.osc.ny.gov/retirement/employers/membership-enrollment/public-officersAccess Controls Over Student Information Systems (2014-MR-1)
… Systems (SIS), to store and manage student data in a centralized database. SIS commonly contain extensive … members and external information technology support staff. In addition, many school districts provide parents and … access to the information. Key Findings Individual users in all six districts were assigned more access rights than …
https://www.osc.ny.gov/local-government/audits/school-district/2014/08/19/access-controls-over-student-information-systems-2014-mr-1DiNapoli: Former Village of Sherman Treasurer Arrested for Alleged Theft of $20,000
… in the third degree. “Ms. Gilbert allegedly betrayed her neighbors by pocketing tax payments to pay her personal … and encourages the public to help fight fraud and abuse. New Yorkers can report allegations of fraud involving …
https://www.osc.ny.gov/press/releases/2022/08/dinapoli-former-village-sherman-treasurer-arrested-alleged-theft-20000DiNapoli Honors Community Leaders During Lunar New Year Celebration
… She serves on several community boards. Honoree Sharon Lee, acting Queens Borough President, has served in several … the redevelopment of LaGuardia and Kennedy Airports. Lee also previously served as senior advisor and press … Awareness Program Training Coordinator, Captain Steven Lee, Captain Man Wai Law and Deputy Chief Sophia Kwok. The …
https://www.osc.ny.gov/press/releases/2020/02/dinapoli-honors-community-leaders-during-lunar-new-year-celebrationAnthem Blue Cross – Coordination of Benefits With Medicare
… and their dependents have other insurance coverage in addition to the Empire Plan such as Medicare, the federal … Medicare-related information. Additionally, weaknesses in Anthem’s and Civil Service’s reconciliation of member … for recovery. Key Recommendations Review the $5,259,416 in claims identified in this report as improperly paid and …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareMedicaid – Federal Funding and New York
… funded by the federal government and the states; in New York, counties and the City of New York also make contributions to the program. While the … disenrolling people from Medicaid for the duration of the public health emergency. Source: NYS Department of Health …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/medicaidMaximizing Drug Rebates Under the Federal Medicaid Drug Rebate Program (Follow-Up)
… – Maximizing Drug Rebates Under the Federal Medicaid Drug Rebate Program (Report 2021-S-11 ). About the Program The … medical service provided to recipients. The Medicaid Drug Rebate Program (MDRP) reduces state and federal expenditures …
https://www.osc.ny.gov/state-agencies/audits/2024/12/20/maximizing-drug-rebates-under-federal-medicaid-drug-rebate-program-followDecarbonization Advisory Panel Report - April 2019
A report on how the Fund can best mitigate investment risks stemming from climate change and maximize opportunities from the new, low-carbon economy.
https://www.osc.ny.gov/files/reports/special-topics/pdf/decarbonization-advisory-panel-2019.pdfEnterprise Fraud, Waste and Abuse Prevention and Detection: Annual Report to the New York State Legislature, 2019
OSC makes recommendations to agencies and other organizations it audits on how to improve data quality and reporting, and implement effective controls.
https://www.osc.ny.gov/files/reports/special-topics/pdf/enterprise-fraud-2019.pdfNYSLRS Record of Activities - Elected and Appointed Officials
This webinar will explain how the New York State and Local Retirement System (NYSLRS) determines service credit for Elected and Appointed Officials.
https://www.osc.ny.gov/files/local-government/academy/pdf/record-of-activities-nyslrs-031925.pdf