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Medicaid Program – Overpayments of Ambulatory Patient Group Claims

… For example, Medicaid paid a provider $149 for a clinic visit that was billed under one particular rate code. … Department of Health: Medicaid Payments for Excessive Dental Services (2009-S-46) …

https://www.osc.ny.gov/state-agencies/audits/2013/08/20/medicaid-program-overpayments-ambulatory-patient-group-claims

Medicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims

… “dual-eligibles.” In 1997, Congress established Medicare Part C, the Medicare managed care program also known as Medicare Advantage. Under Medicare Part C, private managed care companies administer Medicare … plan providers bill Medicaid directly for the enrollee’s Part C cost-sharing liabilities (deductibles, coinsurance, …

https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claims

Selected Financial Management and Administrative Practices

… period. Each Public Administrator maintains a suspense account to pay estate-related expenses not covered by the … of employees who are paid through the suspense account, as otherwise required by governing regulations and … The average monthly balance in the NCPA’s suspense account dropped from $241,214 in 2010, to $74,442 in 2013 ‒ a …

https://www.osc.ny.gov/state-agencies/audits/2015/04/28/selected-financial-management-and-administrative-practices

Medicaid Overpayments for Non-Emergency Out-of-State Inpatient Services (Follow-Up)

… of implementation of the four recommendations included in our initial audit report, Medicaid Overpayments for … payment.  Auditors further identified $10.8 million in claim payments for which the Department had not granted … services. Key Finding Department officials made progress in addressing the issues we identified in the initial audit.  …

https://www.osc.ny.gov/state-agencies/audits/2013/03/11/medicaid-overpayments-non-emergency-out-state-inpatient-services-follow

Medicaid Overpayments for Out-of-State Ambulatory Surgery Services (Follow-Up)

… in our initial audit report, Medicaid Overpayments for Out-of-State Ambulatory Surgery Services (Report … was appropriately paying out-of-state providers for ambulatory surgery services provided to New York State Medicaid recipients. For the period from April 16, 2004 through June 30, 2009, …

https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-overpayments-out-state-ambulatory-surgery-services-follow

Bus Driver Licensing (Follow-Up)

… four recommendations included in our initial report, Bus Driver Licensing (2012-S-30). Background Our initial report, … four recommendations included in our initial report Bus Driver Licensing 2012S30 …

https://www.osc.ny.gov/state-agencies/audits/2016/01/21/bus-driver-licensing-follow

Forensic Audit of Select Payroll and Overtime Practices and Related Transactions (Follow-Up)

… of implementation of 6 recommendations included in our intl report Forensic Audit of Select Payroll Overtime …

https://www.osc.ny.gov/state-agencies/audits/2016/03/18/forensic-audit-select-payroll-and-overtime-practices-and-related-transactions-follow

Empire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Follow-Up)

… of the Plan. Empire processes and pays Plan claims for hospital services in accordance with agreements Empire negotiates with member hospitals. Payments for hospital services are generally based on standard fee …

https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-through

Suspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists (Follow-Up)

… special health care needs. Our initial audit identified a dentist, Lawrence Bruckner, whose Medicaid billing pattern … that were purportedly provided by another affiliated dentist. In addition, the dentists paid staff to recruit …

https://www.osc.ny.gov/state-agencies/audits/2015/12/30/suspicious-and-fraudulent-medicaid-payments-affiliated-brooklyn-dentists-follow

United HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)

… Background Our initial audit report, which was issued on August 13, 2013, determined that, for the period January 1, …

https://www.osc.ny.gov/state-agencies/audits/2016/02/18/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy

Access-A-Ride Accident Claims (Follow-Up)

… ( 2012-S-12 ). Background Our initial report, issued on April 24, 2014, determined that between 2008 and 2012 the … traditional carriers decreased and reliance on the black car services and taxis increased. The number of reported accidents also initially increased, but decreased between …

https://www.osc.ny.gov/state-agencies/audits/2016/05/13/access-ride-accident-claims-follow

Benefit Eligibility Assessment Process (Follow-Up)

… Background Our initial audit, which was issued on May 28, 2014, determined whether the New York City Human … the Office of Temporary and Disability Assistance’s (OTDA) Fair Hearing process was used only as necessary. The audit … through September 30, 2013. We found that HRA applied a fair and consistent assessment process when determining …

https://www.osc.ny.gov/state-agencies/audits/2016/06/16/benefit-eligibility-assessment-process-follow

Compliance With Payment Card Industry Standards

… of New York (SUNY) schools are in compliance with Payment Card Industry (PCI) standards and whether SUNY System … All industries that accept credit cards as a method of payment must comply with the Data Security Standards (DSS) … data. SUNY schools accept credit cards as a method of payment (e.g., for tuition, housing, and meals), and as such …

https://www.osc.ny.gov/state-agencies/audits/2016/06/08/compliance-payment-card-industry-standards

Administration of Tenant Complaints

… New York State Homes and Community Renewal’s Office of Rent Administration addresses tenant complaints in a … New York State Homes and Community Renewal consists of all the State’s housing and community renewal agencies. These agencies include the Division of Housing and Community Renewal (Division), which is …

https://www.osc.ny.gov/state-agencies/audits/2014/12/11/administration-tenant-complaints

Outstanding 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-follow

Safety of Infrastructure (Follow-Up)

… system. As of October 2010, there was a backlog of over $1.1 billion in improvements that needed to be made. In some … to make repairs, but in others had either opted to cordon off certain areas to prevent public access, or in the most … or completed 204 projects with total costs over $221 million using New York Works funds. However, additional work …

https://www.osc.ny.gov/state-agencies/audits/2015/01/06/safety-infrastructure-follow

Procurement and Contracting Practices (Follow-Up)

… in the State, seeking efficiencies, lower costs, and innovative solutions. With an annual budget of about $434 million, the …

https://www.osc.ny.gov/state-agencies/audits/2014/04/16/procurement-and-contracting-practices-follow

State Agency Small-Dollar Purchases (Follow-Up)

… of implementation of the three recommendations included in our initial audit report, State Agency Small-Dollar Purchases (2009-S-56). Background In our initial audit report, which was issued on September 9, … of implementation of the three recommendations included in our initial report. Key Findings OGS officials made …

https://www.osc.ny.gov/state-agencies/audits/2013/11/21/state-agency-small-dollar-purchases-follow

Management of Energy Consumption (Follow-Up)

… Purpose To determine the extent of implementation of the two … OCFS has developed and implemented a centralized plan to reduce energy consumption. OCFS now retains energy usage … Compliance With Executive Order 111 Requirements to Purchase Power From Renewable Sources (2008-S-74) …

https://www.osc.ny.gov/state-agencies/audits/2015/01/06/management-energy-consumption-follow

Assessment 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 … and assessing these costs on participating insurance carriers, self-insurers, and self-insured political … made minor calculation errors in the fiscal year 2011-12 assessment, resulting in a net understatement of $144,592 in …

https://www.osc.ny.gov/state-agencies/audits/2015/04/15/assessment-costs-administer-workers-compensation-program-two-fiscal-years-ended-march-31