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Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… December 2011. Background The New York State Health Insurance Program (NYSHIP) provides health coverage to active … marked up charges by only 17 percent. On one particular claim, we estimate that a hospital made a profit of about … Related Audits/Reports of Interest New York State Health Insurance Program: Empire BlueCross BlueShield Payments Made …
https://www.osc.ny.gov/state-agencies/audits/2013/05/09/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughOperational Training and Medical Assessments of Train Crews (Follow-Up)
… line on Staten Island, which runs from the St. George Ferry Terminal to the southern terminus at the Tottenville …
https://www.osc.ny.gov/state-agencies/audits/2019/12/13/operational-training-and-medical-assessments-train-crews-followCollection of Petroleum Business Tax and Motor Fuel Excise Tax
… in place that allow it to appropriately collect Petroleum Business Tax and Motor Fuel Excise Tax, as required by … of tax forms. Diesel and motor fuel distributors must be registered with the Department to legally conduct petroleum … liability. As of June 2018, there were 1,658 businesses registered with the Department as distributors, retailers, …
https://www.osc.ny.gov/state-agencies/audits/2020/05/20/collection-petroleum-business-tax-and-motor-fuel-excise-taxEmpire BlueCross BlueShield – Payments to John T. Mather Memorial Hospital (Follow-Up)
… Purpose To determine if the recommendations made in our initial audit report, Empire BlueCross … documentation for payments which predate a certain point in time. However, we obtained cost data for 11 of the … To determine if the recommendations made in our initial audit reportNew York State Health Insurance P …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/empire-bluecross-blueshield-payments-john-t-mather-memorial-hospital-followExamination of Unemployment Insurance Benefits
… were to determine if payment requests and payments DOL approved were appropriate and in accordance with … applicable Federal and State laws and regulatio ns and DOL policies and procedures, and if DOL recouped overpayments based on our findings . Background … were to determine if payment requests and payments DOL approved were appropriate and in accordance with …
https://www.osc.ny.gov/state-agencies/audits/2016/09/16/examination-unemployment-insurance-benefitsExamination of Unemployment Insurance Benefits
… of our examination were to determine if: (i) Unemployment Insurance (UI) benefit payment requests and payments made by … Section 597.3 of the State Labor Law on the Unemployment Insurance Program. Consider seeking authority to prevent … of our examination were to determine if i Unemployment Insurance UI benefit payment requests and payments made by …
https://www.osc.ny.gov/state-agencies/audits/2015/10/07/examination-unemployment-insurance-benefitsSelected Performance Measures (Follow-Up)
… Bridges and Tunnels, MTA Construction and Development, Metro-North Railroad (Metro-North), Long Island Rail Road (LIRR), New …
https://www.osc.ny.gov/state-agencies/audits/2022/04/08/selected-performance-measures-followErrors in Identification of 340B Providers in the Medicaid Drug Rebate Program (Follow-Up)
… Purpose To determine the implementation status of the four recommendations made in our initial audit report, Errors in Identification of 340B … To determine the implementation status of the four recommendations made in our initial audit report …
https://www.osc.ny.gov/state-agencies/audits/2018/10/23/errors-identification-340b-providers-medicaid-drug-rebate-program-followRailroad Bridge Inspection Program
… railroads operating in the State to ensure they meet the bridge inspection requirements. This audit covers the period … 1, 2010 through June 30, 2013. Background The Railroad Bridge Inspection Program (Program) provides oversight of the … to ensure public safety and decrease the risk of railroad bridge failures. Department regulations require railroad …
https://www.osc.ny.gov/state-agencies/audits/2013/12/09/railroad-bridge-inspection-programExamination of Unemployment Insurance Benefits
… of our examination were to determine if Unemployment Insurance (UI) payments made by the Department of Labor (DOL) … of our examination were to determine if Unemployment Insurance UI payments made by the Department of Labor DOL …
https://www.osc.ny.gov/state-agencies/audits/2014/06/09/examination-unemployment-insurance-benefitsMedicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… the Restriction Program must receive certain care through only their designated health care providers or via referral …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… Purpose To determine the extent of implementation of the six … of health care services, including prescription drugs, to individuals who are economically disadvantaged and/or have … New York State Controlled Substances Act (Act) was enacted to combat the illegal use of controlled substances. The Act …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followMedicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… with third-party insurers prior to billing Medicaid for services. After processing a claim from a provider, the … Group codes include PR (patient responsibility) and CO (contractual obligation). CARC 45 occurs when the charge … Medicaid members with Medicare and/or other third-party insurance must accurately reflect payments, adjustments …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsDriver Responsibility Assessment Program
… laws enacted to promote safety and protect consumers. In an effort to prevent the repeated behavior of problem drivers and to improve traffic safety, in November 2004, the State Legislature amended the Vehicle … database and its contents. Although ITS has a procedure in place requiring that any manual changes be noted by the …
https://www.osc.ny.gov/state-agencies/audits/2014/10/09/driver-responsibility-assessment-programIgnition Interlock Program Monitoring (2015-MS-4)
… six letter reports to the Counties of Cortland , Erie , Montgomery , Otsego , Suffolk and Wayne . Purpose of Audit … purpose of our audit was to determine if counties using public resources for the State’s Ignition Interlock Program … by criminal courts for these alcohol-related sentences. County probation departments monitor court-ordered …
https://www.osc.ny.gov/local-government/audits/county/2016/04/25/ignition-interlock-program-monitoring-2015-ms-4Security and Effectiveness of the Department of Labor’s Unemployment Insurance System
… 12, 2014 through September 23, 2014. Background The New York State Office of Information Technology Services (ITS) was …
https://www.osc.ny.gov/state-agencies/audits/2015/02/24/security-and-effectiveness-department-labors-unemployment-insurance-systemReporting and Utilization of Bias Incident Data
… is accurately collecting, recording, and reporting bias incident statistics and utilizing the data for management … took place in New York City. The NYPD’s data is drawn from Incident Reports that are prepared by its Hate Crimes Task … 2012, there were data disparities between individual incident reports and summaries of bias-related crimes …
https://www.osc.ny.gov/state-agencies/audits/2014/09/25/reporting-and-utilization-bias-incident-dataCity of Amsterdam – Budget Review (B23-5-4)
… benefits between the operating funds using unsupported allocation methods. Three of the City’s seven collective … 2023-24 and modify the budget as necessary. Develop an allocation plan based on detailed analysis that ensures costs …
https://www.osc.ny.gov/local-government/audits/city/2023/05/05/city-amsterdam-budget-review-b23-5-4Restitution Payments (2021-MS-2)
… cannot identify the source of all the money on deposit in their restitution accounts. As a result, some victims will … orders have remained unsatisfied for the longest period in a timely manner. …
https://www.osc.ny.gov/local-government/audits/county/2021/12/14/restitution-payments-2021-ms-2Overpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… included in our initial audit report, Overpayments for Therapy Services and Prescription Drugs Covered by Medicare … Medicare program covers physical, occupational, and speech therapy services as well as prescription drugs. When these … overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered by …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-follow