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Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… audit report, Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Report 2014-S-5 ). … Medicaid inappropriately paid 29,289 fee-for-services pharmacy claims totaling $978,251 on behalf of 18,010 Medicaid recipients whose pharmacy benefits were covered by managed care. We …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followEffectiveness of the Information Technology Transformation
… Purpose To determine how effective the IT Transformation process has been in ensuring that the … (ITS) clusters operate efficiently and whether the Transformation has been successful in standardizing the … Determine how effective the IT Transformation process has been in …
https://www.osc.ny.gov/state-agencies/audits/2016/08/24/effectiveness-information-technology-transformationPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… of implementation of the three recommendations included in our initial audit report, Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy … 10, 2015, William Davis pleaded guilty to Grand Larceny in the Second Degree in Nassau County District Court. He was …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Plan covers many health care services, … September 26, 2014, identified $694,227 in drug rebate and discount revenue that was not credited to the Department for … the Department was credited with all drug rebate and discount revenue due to the State. We recommended that United …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations made in our audit report, New … benefits plan for NYSHIP. The New York State Department of Civil Service contracts with Empire BlueCross BlueShield … To determine the extent of implementation of 3 recommendations made in our audit …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughInspecting Highway Bridges and Repairing Defects (Follow-Up)
… 2014, found that the Port Authority of New York and New Jersey (Authority) did not follow the New York State …
https://www.osc.ny.gov/state-agencies/audits/2016/06/30/inspecting-highway-bridges-and-repairing-defects-followAnnual Assessment of Market Orders for 2012, 2013, and 2014
… was to determine whether the Department of Agriculture and Markets (Department) has adequate procedures in place to accurately report its assessable expenses related … to its administration of Article 25 of the Agriculture and Markets Law. We performed our audit pursuant to …
https://www.osc.ny.gov/state-agencies/audits/2015/05/07/annual-assessment-market-orders-2012-2013-and-2014Empire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… report, Empire BlueCross BlueShield: Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … audit report Empire BlueCross BlueShield Selected Payments for Special Items …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughHousing Preferences for Veterans (Follow-Up)
… City Department of Housing Preservation and Development (NYC HPD). We specifically found two housing companies in … veterans had been identified on their waiting lists. NYC HPD approved many of these non-veterans’ applications, … included in our initial report. Key Finding NYC HPD has made progress in addressing the issues identified …
https://www.osc.ny.gov/state-agencies/audits/2015/01/29/housing-preferences-veterans-followOpinion 2002-11
… under a fire district service award program that provides points for participation in department responses, a volunteer firefighter must be credited with twenty-five points for responding to the minimum number of calls of the … the General Municipal Law, and an additional twenty-five points for responding to the minimum number of fire company …
https://www.osc.ny.gov/legal-opinions/opinion-2002-11-0Opinion 2000-15
… Law §209-i. You ask whether a volunteer firefighter who resides in another state and is a member of an out-of-state volunteer fire department may … provides in relevant part that a "volunteer firefighter" 1 who, because of his or her residence or usual occupation, is …
https://www.osc.ny.gov/legal-opinions/opinion-2000-15State Agencies Bulletin No. 647
… Background Recently, a binding arbitration award was made in accordance with section 209 of the Civil … Bargaining Unit are eligible for binding arbitration, the award is limited to those eligible employees. Arbitration … Date(s) Changes will take effect for checks dated 8/17/06 (Institution) and 8/23/06 (Administration) OSC Actions OSC has …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/647-new-bargaining-unit-payroll-code-change-non-arbitration-eligibleOverpayments for Medicare Part C Coinsurance Charges (Follow-Up)
… included in our initial audit report, Overpayments for Medicare Part C Coinsurance Charges (2011-S-33). Background … rendered to Medicaid recipients enrolled in a Healthfirst Medicare Advantage Plan. Many Medicaid recipients are also enrolled in Medicare Part C. Under Medicare Part C, managed care plans …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/overpayments-medicare-part-c-coinsurance-charges-followRebates and Discounts on Physician-Administered Drugs (Follow-Up)
… report, Rebates and Discounts on Physician-Administered Drugs (2010-S-72). Background Physician-administered drugs, … in an office setting. To reduce Medicaid costs for prescription drugs, the federal government established the …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/rebates-and-discounts-physician-administered-drugs-followNew York Psychiatric Center – Controls Over State Resources (Follow-Up)
… Psychiatric Institute (Institute), established in 1895, is one of two clinical research facilities administered by … relating to the treatment of mental illness. The Institute is funded by a combination of State appropriations and … the Institute was not receiving the ownership and royalty rights for certain patented technologies developed on …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/new-york-psychiatric-center-controls-over-state-resources-followMedicaid Claims Processing Activity October 1, 2008 Through March 31, 2009 (Follow-Up)
… of implementation of the eight recommendations included in our initial audit report, Medicaid Claims Processing … providers, were accurately processed, and resulted in correct provider payments. We identified five reportable … system. The remaining four reportable conditions resulted in overpayments of approximately $1.2 million. Key Finding …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/medicaid-claims-processing-activity-october-1-2008-through-march-31-2009-followContracts for Personal and Miscellaneous Services (Follow-Up)
… of implementation of the five recommendations included in our initial audit report, Contracts for Personal and Miscellaneous Services ( 2009-S-54 ). Background Our … renewed contracts for personal and miscellaneous services. In addition, the Port Authority did not provide documentation …
https://www.osc.ny.gov/state-agencies/audits/2014/01/07/contracts-personal-and-miscellaneous-services-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… of Transportation was not always notified of red flags within one week, as required. Furthermore, the initial …
https://www.osc.ny.gov/state-agencies/audits/2014/06/25/inspecting-highway-bridges-and-repairing-defects-followTravel Plaza Revenues and Capital Improvements (Follow-Up)
… included in our initial audit report, Travel Plaza Revenues and Capital Improvements (Report 2008-S-103). … included in our initial audit report Travel Plaza Revenues and Capital Improvements …
https://www.osc.ny.gov/state-agencies/audits/2014/08/14/travel-plaza-revenues-and-capital-improvements-followAccuracy of Reported Discharge Data (Follow-Up)
… the New York State Education Department. We found that DoE classified some students as discharged without sufficient … the 500 (14.8 percent) randomly selected students who were classified as discharged were not supported with required … documentation, and all 74, therefore, should have been classified as dropouts. By classifying them as discharged, …
https://www.osc.ny.gov/state-agencies/audits/2014/09/09/accuracy-reported-discharge-data-follow