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Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member …
https://www.osc.ny.gov/state-agencies/audits/2013/05/09/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughAdministration of Fellowship Leaves
… are awarded such leaves for authorized purposes and are in compliance with all applicable requirements. The audit … improve the recipient's teaching skills, perform research in the recipient's respective field of study, or conduct creative works in literature or the arts. Fellowship recipients are required …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/administration-fellowship-leavesUnitedHealthcare: Improper Payments for Acupuncture and Acupuncture-Related Services
… acupuncture service. Key Findings We identified $7,331,458 in actual and potential overpayments for services not … payments during our audit period. We found: $210,068 in overpayments from a random sample of 836 services, from 10 … that United made overpayments of $7,010,427. $223,765 in duplicate payments for services already paid on another …
https://www.osc.ny.gov/state-agencies/audits/2021/10/27/unitedhealthcare-improper-payments-acupuncture-and-acupuncture-related-servicesExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… of deductibles and coinsurance that Medicaid would pay on FFS claims for dual-eligibles. The objective of our … prior to the date the new IB-Dual rate became effective. Key Findings DOH officials have made significant progress in … two were implemented and two were partially implemented. Key Recommendation DOH officials are requested, but not …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… of implementation of the five recommendations included in our initial audit report, Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (Report 2020-S-35 ). … program. Many Medicaid recipients are also enrolled in Medicare. Under the Medicare buy-in program (Buy-in …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
… providers. When a hospital bills an MCO for an inpatient stay, the hospital reports certain information on its claims, … patient was transferred or discharged at the end of their stay. These codes are important because reimbursement …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followReal Estate Portfolio (Follow-Up)
… Purpose To determine the extent of implementation of the nine recommendations included in our initial report, Real … The New York Power Authority’s (NYPA) mission is to “provide clean, low-cost and reliable energy consistent … To determine the extent of implementation of the nine …
https://www.osc.ny.gov/state-agencies/audits/2018/12/28/real-estate-portfolio-followDepartment of Health (Department) Examination of Travel Expenses
… Purpose The objective of our examination was to determine if the travel expenses claimed by a Department employee during the period of February 23, 2012 through December 31, 2017 were … The objective of our examination was to determine if the travel expenses claimed by a Department employee during the period of February 23 2012 …
https://www.osc.ny.gov/state-agencies/audits/2019/03/20/department-health-department-examination-travel-expensesOperational Training and Medical Assessments of Train Crews (Follow-Up)
… and how to respond in situations that may delay trains en route, it is essential that SIR ensure train crews take …
https://www.osc.ny.gov/state-agencies/audits/2019/12/13/operational-training-and-medical-assessments-train-crews-followAdequacy of 2021 Budgets - City of Saratoga Springs (S9-21-10)
… and temporarily or permanently reduce staff positions. In addition, some local officials have decided to delay capital projects, which could result in future delays to other projects to maintain and improve … Springs (City) is one of the local governments included in our review. The City is located in Saratoga County. Key …
https://www.osc.ny.gov/local-government/audits/city/2021/05/14/adequacy-2021-budgets-city-saratoga-springs-s9-21-10Service-Disabled Veteran-Owned Business Program Implementation (Follow-Up)
… our initial audit report, Service-Disabled Veteran-Owned Business Program Implementation (Report 2015-S-81 ) . Background The Service-Disabled Veteran-Owned Business Act (Act) was signed into law on May 12, 2014 to … contracting opportunities. To qualify as a SDVOB, business owners must have received a service-related …
https://www.osc.ny.gov/state-agencies/audits/2018/04/16/service-disabled-veteran-owned-business-program-implementation-followReporting and Utilization of Bias Incident Data (Follow-Up)
… initial audit report, Reporting and Utilization of Bias Incident Data, issued September 25, 2014 ( 2014-N-2 ) . … is accurately collecting, recording, and reporting bias incident statistics and utilizing the data for management … that the NYPD has begun efforts to review and reconcile incident reports to assure that all bias incidents are …
https://www.osc.ny.gov/state-agencies/audits/2016/08/12/reporting-and-utilization-bias-incident-data-followLicense Fee Revenues (Follow-Up)
To determine the extent of implementation of the five recommendations included in our initial audit report License Fee Revenues Report 2010N1
https://www.osc.ny.gov/state-agencies/audits/2013/09/05/license-fee-revenues-followReview of Growe Technologies Inc.
… and paid reasonable prices for those services. Background In January 2009 through federal legislation, the Centers for … health records called Meaningful Use (MU) and ICD-10. In November 2013, the Health Science Center at Brooklyn … IT services to implement MU and ICD-10 at Downstate. In April 2014, Downstate entered into a subsequent, …
https://www.osc.ny.gov/state-agencies/audits/2016/02/19/review-growe-technologies-incControls Over Cash Advance Accounts
… Purpose To determine whether the State Education Department (SED) has … controls over the cash advance accounts it oversees to ensure the money is properly accounted for and used for … To determine whether the State Education Department SED has …
https://www.osc.ny.gov/state-agencies/audits/2014/09/08/controls-over-cash-advance-accountsCollege at Cortland – Selected 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 … 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/2013/02/13/college-cortland-selected-employee-travel-expensesCollege at Brockport – Selected 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 … 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/2013/02/28/college-brockport-selected-employee-travel-expensesSelected Payments for Special Items Made to St. Francis Hospital of Poughkeepsie from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield’s (Empire’s) payments to St. Francis Hospital of Poughkeepsie (St. Francis) for special items were made according to the provisions of the agreement between Empire and St. Francis. Background The New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-francis-hospital-poughkeepsie-january-1-2011York College – Time and Attendance Practices for Public Safety Staff (Follow-Up)
… Purpose To determine the extent of implementation of the seven recommendations included in our initial audit … cameras found that security officers who were assigned to the fire watch spent long periods of time in one area … To determine the extent of implementation of the seven …
https://www.osc.ny.gov/state-agencies/audits/2018/12/28/york-college-time-and-attendance-practices-public-safety-staff-followOrleans County – Court and Trust Funds (2024-C&T-6)
… appropriate controls to safeguard and account for court and trust funds for the period January 1, 2021 through November 1, 2024. Background Pursuant to a court order, certain assets may be provided to the court and then delivered to the County Treasurer (Treasurer) …
https://www.osc.ny.gov/local-government/audits/court-and-trust/2024/12/13/orleans-county-court-and-trust-funds-2024-ct-6