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Medicaid Program – Overpayments of Ambulatory Patient Group Claims
… overpaid Ambulatory Patient Groups (APG) claims because of deficiencies in the claims processing and payment system. … reimbursed based on a patient's condition and complexity of service. The APG system was adopted by the Department of Health (Department) in an effort to more accurately pay …
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
… Part C cost-sharing liabilities (deductibles, coinsurance, and copayments). Key Finding From a review of Medicare Part C … copayments, or deductibles. Ten providers adjusted and re-submitted their claims to eMedNY resulting in Medicaid …
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
… heirs who are not qualified or willing to administer the estate. They are responsible for collecting, securing, and liquidating each assumed estate’s assets in order to pay valid claims against that estate. After all reasonable expenses have been paid, the …
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)
… payments for which the Department had not granted the required prior approvals. Our initial audit report contained …
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)
… York State Medicaid recipients. For the period from April 16, 2004 through June 30, 2009, auditors identified $12.2 … in the initial audit. This included the recovery of $1,309,960. Of the two prior audit recommendations, both have …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-overpayments-out-state-ambulatory-surgery-services-followBus Driver Licensing (Follow-Up)
… of the four recommendations included in our initial report, Bus Driver Licensing (2012-S-30). Background Our initial report, issued on June 13, 2013, determined that the majority … 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)
… in our initial report, Forensic Audit of Select Payroll and Overtime Practices and Related Transactions (2010-S-60). Background Our initial … that these practices cost Metro-North $991,208 in overtime and $216,128 n regular pay, and enriched certain staff and …
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)
… 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-throughSuspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists (Follow-Up)
… through June 8, 2011, Medicaid paid about $6.9 million for services purportedly performed by the six dentists at the … also found that the dentists routinely certified claims for services that were purportedly provided by another … our findings to the State Attorney General’s Office for further investigation. In August 2012, Lawrence Bruckner …
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)
… - Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Report 2012-S-10). Background Our … Plan (NYSHIP) made improper payments totaling $137,459 to Davis Ethical Pharmacy. Based on information obtained from … indicated on the claims), auditors determined that Davis Ethical likely fabricated nearly all of the improper …
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)
… by traditional carriers decreased and reliance on the black car services and taxis increased. The number of … there was an unquantified liability risk associated with black car services and taxis that was expanding and was not …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/access-ride-accident-claims-followBenefit Eligibility Assessment Process (Follow-Up)
… policies and procedures, and whether the Office of Temporary and Disability Assistance’s (OTDA) Fair Hearing … Other Related Audit/Report of Interest Office of Temporary and Disability Assistance and NYC Human Resources …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/benefit-eligibility-assessment-process-followCompliance With Payment Card Industry Standards
… in the United States, consisting of 64 institutions and about 460,000 enrolled students. SUNY System Administration … Key Findings SUNY schools were generally knowledgeable about PCI compliance and the need to protect credit card data …
https://www.osc.ny.gov/state-agencies/audits/2016/06/08/compliance-payment-card-industry-standardsAdministration of Tenant Complaints
… New York State Homes and Community Renewal’s Office of Rent Administration addresses tenant complaints in a timely … housing in New York State. The Division’s Office of Rent Administration (Office), the subject of this audit, is responsible for administering New York State’s rent laws. These laws are designed to provide decent, …
https://www.osc.ny.gov/state-agencies/audits/2014/12/11/administration-tenant-complaintsOutstanding Violations (Follow-Up)
… our initial audit report, Outstanding Violations (Report 2010-N-5 ). Background Our initial report, issued on December … York City Department of Buildings: Outstanding Violations (2010-N-5) …
https://www.osc.ny.gov/state-agencies/audits/2014/10/15/outstanding-violations-followSafety of Infrastructure (Follow-Up)
… implementation of the two recommendations included in our original report, Safety of Infrastructure (2012-S-29). … implementation of the two recommendations included in our original report Safety of Infrastructure 2012S29 …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/safety-infrastructure-followProcurement and Contracting Practices (Follow-Up)
To determine the extent of implementation of the eight recommendations included in our initial audit report Procurement and Contracting Practices
https://www.osc.ny.gov/state-agencies/audits/2014/04/16/procurement-and-contracting-practices-followState Agency Small-Dollar Purchases (Follow-Up)
… voucher processes instead of the State procurement card, and to identify potential cost savings and revenue enhancements achievable through better use of … their usage, 51 did not have P-Cards during either year, and one used the P-Card for all purchases during both years. …
https://www.osc.ny.gov/state-agencies/audits/2013/11/21/state-agency-small-dollar-purchases-followManagement of Energy Consumption (Follow-Up)
… recommendations made in our initial report, Management of Energy Consumption ( 2011-S-4 ). Background Our initial … determined OCFS officials were not effectively managing energy consumption and had not achieved the 35 percent energy reduction goals set forth in Executive Order 111. Key …
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
… these statutes, which direct that the Comptroller and the Chair of the Board ascertain the annual amount of expenses …
https://www.osc.ny.gov/state-agencies/audits/2015/04/15/assessment-costs-administer-workers-compensation-program-two-fiscal-years-ended-march-31