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Medicaid Program – Overpayments of Ambulatory Patient Group Claims
… because of deficiencies in the claims processing and payment system. The audit covered the period December 1, 2008 … 31, 2012. Background The Ambulatory Patient Groups (APG) payment methodology covers most medical outpatient services. … and complexity of service were not factored into the claim payment. Under the new APG system, the Department assigned …
https://www.osc.ny.gov/state-agencies/audits/2013/08/20/medicaid-program-overpayments-ambulatory-patient-group-claimsMedicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… identify Medicaid overpayments made to medical providers for services rendered to recipients enrolled in UnitedHealthcare’s Medicare Advantage plan: UnitedHealthcare Dual Complete. The … of participating providers they reimburse directly for services provided to enrollees. For dual-eligibles, plan …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsSelected Financial Management and Administrative Practices
… of the Nassau County Public Administrator (NCPA) operates in compliance with governing statutes and guidelines. Our … Act establishes a Court-appointed Public Administrator in 11 counties in the State, including Nassau County. Public Administrators … of the Nassau County Public Administrator NCPA operates in compliance with governing statutes and guidelines …
https://www.osc.ny.gov/state-agencies/audits/2015/04/28/selected-financial-management-and-administrative-practicesMedicaid 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-followMedicaid Overpayments for Out-of-State Ambulatory Surgery Services (Follow-Up)
… of implementation of the two recommendations included in our initial audit report, Medicaid Overpayments for … through June 30, 2009, auditors identified $12.2 million in actual and potential Medicaid overpayments to out-of-state … of September 30, 2012, of the two recommendations included in our initial report. Key Finding Department and Office of …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-overpayments-out-state-ambulatory-surgery-services-followBus Driver Licensing (Follow-Up)
To determine the extent of implementation of the 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-followForensic Audit of Select Payroll and Overtime Practices and Related Transactions (Follow-Up)
… of implementation of the six recommendations included in our initial report, Forensic Audit of Select Payroll and … determined that these practices cost Metro-North $991,208 in overtime and $216,128 n regular pay, and enriched certain staff and supervisors. In addition these payments will inflate future pension …
https://www.osc.ny.gov/state-agencies/audits/2016/03/18/forensic-audit-select-payroll-and-overtime-practices-and-related-transactions-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 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 … Determine 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-january-1-2012-throughSuspicious 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-followUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… included in our initial audit report, United HealthCare - Payments for Fraudulent and Improper Claims … patients actually picked-up the drugs billed to United HealthCare (United). Moreover, as a result of our audit, we … of Interest New York State Health Insurance Plan: United HealthCare - Payments for Fraudulent and Improper Claims …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyAccess-A-Ride Accident Claims (Follow-Up)
… included in our initial report, Access-A-Ride Accident Claims ( 2012-S-12 ). Background Our initial report, … recommendations included in our initial report AccessARide Accident Claims 2012S12 …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/access-ride-accident-claims-followBenefit Eligibility Assessment Process (Follow-Up)
… of implementation of the three recommendations included in our initial audit report, Benefit Eligibility Assessment … assessment process when determining client eligibility in compliance with governing policies and procedures. We also … number of overturned HRA determinations and costly, and in some cases unnecessary, OTDA Fair Hearings. These hearings …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/benefit-eligibility-assessment-process-followCompliance With Payment Card Industry Standards
… selected State University of New York (SUNY) schools are in compliance with Payment Card Industry (PCI) standards and … York (SUNY) is the largest comprehensive university system in the United States, consisting of 64 institutions and about … Among a range of issues, we identified weaknesses in: the completeness of systems’ component inventories; …
https://www.osc.ny.gov/state-agencies/audits/2016/06/08/compliance-payment-card-industry-standardsAdministration of Tenant Complaints
… Office of Rent Administration addresses tenant complaints in a timely manner. Our audit period includes … development of affordable low- and moderate-income housing in New York State. The Division’s Office of Rent … three years - to be assigned. Of the complaints received in our scope period, 1,101 remained unassigned as of March 6, …
https://www.osc.ny.gov/state-agencies/audits/2014/12/11/administration-tenant-complaintsOutstanding Violations (Follow-Up)
… of implementation of the four recommendations included in our initial audit report, Outstanding Violations (Report … (Department) managers did not have effective systems in place to ensure hazardous violations were resolved … of September 9, 2014, of the four recommendations included in our initial report. Key Finding The Department has made …
https://www.osc.ny.gov/state-agencies/audits/2014/10/15/outstanding-violations-followSafety of Infrastructure (Follow-Up)
… of implementation of the two recommendations included in our original report, Safety of Infrastructure (2012-S-29). … identified. We found staff were actively involved in inspecting facilities and repairing any hazardous … of October 2010, there was a backlog of over $1.1 billion in improvements that needed to be made. In some cases, staff …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/safety-infrastructure-followProcurement and Contracting Practices (Follow-Up)
… of implementation of the eight recommendations included in our initial audit report, Procurement and Contracting Practices (Report 2010-S-71). Background In our initial audit report, which was issued on February 28, … as the New York State Office for Technology, resulted in the best value for taxpayers, consistent with applicable …
https://www.osc.ny.gov/state-agencies/audits/2014/04/16/procurement-and-contracting-practices-followState Agency Small-Dollar Purchases (Follow-Up)
… included in our initial audit report, State Agency Small-Dollar Purchases (2009-S-56). Background In our … Audit/Report of Interest Office of General Services: State Agency Small-Dollar Purchases (2009-S-56) … recommendations included in our initial audit report State Agency SmallDollar Purchases …
https://www.osc.ny.gov/state-agencies/audits/2013/11/21/state-agency-small-dollar-purchases-followManagement of Energy Consumption (Follow-Up)
… extent of implementation of the two recommendations made in our initial report, Management of Energy Consumption ( … achieved the 35 percent energy reduction goals set forth in Executive Order 111. Key Findings We determined that OCFS has implemented both recommendations made in our initial report. OCFS has developed and implemented a …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/management-energy-consumption-followAssessment of Costs to Administer the Workers’ Compensation Program for the Two Fiscal Years Ended March 31, 2013
… Compensation Board (Board) has adequate procedures in place to accurately report its assessable expenses related … our audit pursuant to legislative mandates included in these statutes, which direct that the Comptroller and the … the Board ascertain the annual amount of expenses incurred in the administration of these Laws. Our audit covered the …
https://www.osc.ny.gov/state-agencies/audits/2015/04/15/assessment-costs-administer-workers-compensation-program-two-fiscal-years-ended-march-31