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Empire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… of the Plan. Empire processes and pays Plan claims for hospital services in accordance with agreements Empire negotiates with member hospitals. Payments for hospital services are generally based on standard fee …
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)
… three recommendations made in our initial audit report, United HealthCare Insurance Company of New York: Empire Plan … Department of Civil Service (Department) contracted with United HealthCare (United) to administer the Plan’s … of Interest New York State Health Insurance Program: United HealthCare: Payments for Fraudulent and Improper …
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)
… initial audit report, Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). … from the prescribers (the physicians indicated on the claims), auditors determined that Davis Ethical likely fabricated nearly all of the improper claims. Davis Ethical processed many of the improper claims …
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
… separate audits of the security and effectiveness of core systems at three major agencies, each organized within a … Criminal Justice Services; and the ease and efficiency of core programming languages at the Department of Labor and the … Effectiveness of Division of Criminal Justice Services’ Core Systems (2014-S-24) Office of Information Technology …
https://www.osc.ny.gov/state-agencies/audits/2016/08/24/effectiveness-information-technology-transformationUse of State Appropriations
… Purpose To determine whether the New York Wine and Grape Foundation (Foundation) has spent … a public authority, located in Canandaigua, which supports New York State’s wine and grape industry through research, … receives State funding through a contract with the New York State Department of Agriculture and Markets …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/use-state-appropriationsContracts for Personal and Miscellaneous Services (Follow-Up)
… included in our initial audit report, Contracts for Personal and Miscellaneous Services ( 2008-S-158 ). … required to maintain documentation supporting the basis for this determination, and we found such documentation was … requesting the services determine whether: it was feasible for another constituent agency to perform some or all of the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/contracts-personal-and-miscellaneous-services-followHousing Preferences for Veterans (Follow-Up)
… included in our initial audit report, Housing Preferences for Veterans (Report 2011-N-3 ). Background Our initial … State Legislature had extended the right of preference for housing to many more veterans, few actually benefited due … included in our initial audit report Housing Preferences for Veterans Report 2011N3 …
https://www.osc.ny.gov/state-agencies/audits/2015/01/29/housing-preferences-veterans-followRainbow Rhymes Learning Center (Follow-Up)
… State Education Department: Rainbow Rhymes Learning Center (Report 2009-S-84). Background Our initial audit … (Department) grant payments to Rainbow Rhymes Learning Center (Rainbow) were appropriate and adequately supported. … State Education Department: Rainbow Rhymes Learning Center Report (2009-S-84) …
https://www.osc.ny.gov/state-agencies/audits/2013/06/27/rainbow-rhymes-learning-center-followAccuracy of Reported Discharge Data (Follow-Up)
… when we examined DoE’s discharge classifications for its 2004-08 general education cohort (i.e., the students …
https://www.osc.ny.gov/state-agencies/audits/2014/09/09/accuracy-reported-discharge-data-followTravel Plaza Revenues and Capital Improvements (Follow-Up)
… Purpose To determine the extent of implementation of the eight … which was issued on January 15, 2010, our objective was to determine whether the New York State Thruway Authority … contracts. We found that the NYSTA's efforts were adequate to ensure fuel and food concessionaires pay full rent on time …
https://www.osc.ny.gov/state-agencies/audits/2014/08/14/travel-plaza-revenues-and-capital-improvements-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… Purpose To determine the extent of implementation of the three … was issued on Report April 26, 2013, our objective was to determine whether the New York State Thruway Authority … To determine the extent of implementation of the three …
https://www.osc.ny.gov/state-agencies/audits/2014/06/25/inspecting-highway-bridges-and-repairing-defects-followContracts for Personal and Miscellaneous Services (Follow-Up)
… in our initial audit report, Contracts for Personal and Miscellaneous Services ( 2009-S-54 ). Background Our … 19, 2011, determined that the Port Authority of New York and New Jersey (Port Authority) generally did not have … justify the need for new or renewed contracts for personal and miscellaneous services. In addition, the Port Authority …
https://www.osc.ny.gov/state-agencies/audits/2014/01/07/contracts-personal-and-miscellaneous-services-followMedicaid Claims Processing Activity October 1, 2008 Through March 31, 2009 (Follow-Up)
… were accurately processed, and resulted in correct provider payments. We identified five reportable conditions. The first reportable condition entailed the identification and … Other Related Audits/Reports of Interest Department of Health: Medicaid Claims Processing Activity October 1, 2008 …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/medicaid-claims-processing-activity-october-1-2008-through-march-31-2009-followNew York Psychiatric Center – Controls Over State Resources (Follow-Up)
… Institute (Institute), established in 1895, is one of two clinical research facilities administered by the Office of Mental Health (OMH). The Institute conducts clinical trials and research studies relating to the …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/new-york-psychiatric-center-controls-over-state-resources-followRebates and Discounts on Physician-Administered Drugs (Follow-Up)
… in our initial audit report, Rebates and Discounts on Physician-Administered Drugs (2010-S-72). Background … qualified providers. Providers are required to pass on the savings to Medicaid when they submit claims for 340B drugs. Our initial audit report, which was issued on July 24, 2012, determined the Department of Health had …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/rebates-and-discounts-physician-administered-drugs-followOverpayments 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 … Plan. Many Medicaid recipients are also enrolled in Medicare Part C. Under Medicare Part C, managed care plans (also known as Medicare … included in our initial audit report Overpayments for Medicare Part C Coinsurance Charges …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/overpayments-medicare-part-c-coinsurance-charges-followOversight of Grants (Follow-Up)
… as of March 7, 2014 of the eight recommendations in our initial audit report, Oversight of Grants (2009-S-78). … Key Findings Department officials have made progress in correcting the problems identified in our initial report. Of the eight prior audit … as of March 7 2014 of the eight recommendations in our initial audit report Oversight of Grants …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/oversight-grants-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… extent of implementation of the three recommendations made in our audit report, Empire BlueCross BlueShield: Selected … Empire processes and pays 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/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughAnnual Assessment of Market Orders for 2012, 2013, and 2014
… has adequate procedures in place to accurately report its assessable expenses related to its administration … Follow up on the questionable expenses identified in our report and seek repayment for any inappropriate or ineligible … source justification requirements. Other Related Audit/Report of Interest Department of Agriculture and Markets: …
https://www.osc.ny.gov/state-agencies/audits/2015/05/07/annual-assessment-market-orders-2012-2013-and-2014Collection of Medicaid Accounts Receivable (Follow-Up)
… Background Our initial audit report, which was issued on September 9, 2010, examined whether the Department of … and seek recovery of accounts receivable that were owed by providers when they joined a group practice. We also … 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/2013/09/05/collection-medicaid-accounts-receivable-follow