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Medicaid Drug Rebate Program Under Managed Care (Follow-Up)
… Under Managed Care (Report 2014-S-41 ). Background The State’s Medicaid program provides a wide range of health care … by the Department. Given the current fiscal stress on state Medicaid programs, we strongly urge the Department to …
https://www.osc.ny.gov/state-agencies/audits/2017/06/30/medicaid-drug-rebate-program-under-managed-care-followEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member hospitals. Payments for hospital services are generally based on standard fee …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughAdoption Subsidy Program (Follow-Up)
… Background Our initial audit report, which was issued on August 18, 2010, examined whether adoption subsidy … issuance of the follow-up review to provide information on any actions that are planned to address the unresolved …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/adoption-subsidy-program-followBenefit Eligibility Assessment Process
… Purpose To determine whether the New York City Human Resources … (Client) eligibility, and when a Client is determined to be ineligible, denying, reducing or terminating the Client's benefits. As a last resort, Clients deemed to be ineligible are entitled to a Fair Hearing administered …
https://www.osc.ny.gov/state-agencies/audits/2014/05/28/benefit-eligibility-assessment-processPipeline Safety Oversight
… natural gas and hazardous liquids, including crude oil, refined petroleum products, and other highly volatile, … Program, Inspection Activity, Inspector Qualification, Leak Management, Enforcement, and Incident Investigation. Key … of Environmental Conservation: Collection and Use of Oil Spill Funds (2014-S-59) …
https://www.osc.ny.gov/state-agencies/audits/2016/03/08/pipeline-safety-oversightSelected Aspects of Inactive Hazardous Waste Site Remediation Cost Recovery
… Conservation (Department) has effective systems in place to fully and accurately accumulate State costs … bill for and collect these costs from responsible parties in a timely manner, and identify and pursue parties … (Program), also known as the State Superfund Program, in New York. The purpose of the Program is to identify, …
https://www.osc.ny.gov/state-agencies/audits/2015/01/22/selected-aspects-inactive-hazardous-waste-site-remediation-cost-recoveryAccounts Receivable Collection and Reporting
… receivable collection and reporting procedures were in compliance with applicable laws and regulations for the … receivable collection and reporting practices are in compliance with applicable laws and regulations. As required, … receivable collection and reporting procedures were in compliance with applicable laws and regulations for the …
https://www.osc.ny.gov/state-agencies/audits/2015/08/05/accounts-receivable-collection-and-reportingMedicaid Program – Medicaid Drug Rebate Program Under Managed Care
… Purpose To determine whether the Department of Health (Department) has taken appropriate steps to maximize rebate collections on drugs dispensed to … To determine whether the Department of Health has taken …
https://www.osc.ny.gov/state-agencies/audits/2015/02/18/medicaid-program-medicaid-drug-rebate-program-under-managed-careMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background Our … was issued on December 9, 2010, examined whether nursing home claims submitted to Medicaid for hospital bed reserve … days were appropriate, and if not, to what extent nursing home claims exceeded the bed reserve day limits. During the …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followOversight of Homeless Shelters
… – estimated at more than 80,000 and comprised of families, couples, and single adults – while guiding them to …
https://www.osc.ny.gov/state-agencies/audits/2016/02/12/oversight-homeless-sheltersSelected Operating and Administrative Practices of the Bureau of Narcotic Enforcement (Follow-Up)
… was effectively and efficiently combating prescription drug diversion and abuse in New York State, in large part … to ensure its resources are used effectively to stem drug diversion and abuse through a range of efforts, from …
https://www.osc.ny.gov/state-agencies/audits/2015/09/23/selected-operating-and-administrative-practices-bureau-narcotic-enforcement-followImproper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… included in our initial audit report, Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Report … which was issued on January 5, 2015, determined that, for the 27-month period October 1, 2011 through December 31, … our initial audit report Improper FeeforService Payments for Pharmacy Services …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followControls Over Cash Advance Accounts (Follow-Up)
… Background Our initial audit report, which was issued on December 22, 2014, determined whether Parks needs their … issuance of the follow-up review to provide information on any actions that are planned to address the unresolved …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/controls-over-cash-advance-accounts-followForensic Audit of Payments to On-Board Service Managers (Follow-Up)
… Services Unit staff members were not held accountable for their work performance and time and attendance. In addition, the Assistant Vice President responsible for the Unit violated Metro-North policy by not disclosing …
https://www.osc.ny.gov/state-agencies/audits/2016/01/21/forensic-audit-payments-board-service-managers-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… Defects ( 2012-S-34 ). Background Our initial audit issued on May 19, 2014, found that the Port Authority of New York … issuance of the follow-up review to provide information on any actions that are planned to address the unresolved …
https://www.osc.ny.gov/state-agencies/audits/2016/06/30/inspecting-highway-bridges-and-repairing-defects-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… coverage to active and retired State, participating local government and school district employees, and their … accordance with agreements Empire negotiates with member hospitals. Payments for hospital services are generally based … are negotiated between Empire and its member providers. Hospitals may be entitled to additional payments for special …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… made in our initial audit report, United HealthCare Insurance Company of New York: Empire Plan Drug Rebate … made in our intl audit report United HealthCare Insurance Company of New York Empire …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… with the Nassau County District Attorney and the New York State Department of Financial Services. On December 10, 2015, … February 9, 2016, and made restitution of $231,919 to the State, of which $94,460 was paid to the Medicaid for the … William Davis made full restitution of $231,919 to the State, of which $94,460 was paid to Medicaid for the improper …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followEffectiveness of the Information Technology Transformation
… of recurring turnover among top-level ITS executives. ITS is still working toward completion of several of the goals … as “well underway” at the time. However, we found that ITS is currently in its fourth year, and only one of these … and Integration) has shown significant progress and is ostensibly complete. The status of the other three (Data …
https://www.osc.ny.gov/state-agencies/audits/2016/08/24/effectiveness-information-technology-transformationUse of State Appropriations
… April 2012 through March 2016. Background The Foundation is a public authority, located in Canandaigua, which supports … industry through research, promotion, and education. It is governed by a Board of Directors, most of whom are … commitment to leverage State money. Although it is only required to obtain outside funding equal to what the …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/use-state-appropriations