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Alternatives For Children – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Alternatives For Children (Alternatives) on its Consolidated Fiscal … The audit covered expenses reported on Alternatives’ CFR for the fiscal year ended June 30, 2015, and certain expenses reported on Alternatives’ CFRs for the two fiscal years ended June 30, 2014. Background …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/alternatives-children-compliance-reimbursable-cost-manualOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… for Services Also Covered by Medicare Part B (Report 2012-S-27). Background Many of the State’s Medicaid … Medicare for the Part B services they provide. FQHCs are “safety net” providers, such as community health centers and … for Services Also Covered by Medicare Part B (2012-S-27) Department of Health: Overpayments for Services …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followSubway Service Diversions for Maintenance and Capital Projects (Follow-Up)
… Purpose To determine the extent of implementation of the five … in our initial audit report, Subway Service Diversions for Maintenance and Capital Projects ( 2010-S-34 ). … managing and controlling subway diversions, more needed to be done. Specifically, the prior audit found that …
https://www.osc.ny.gov/state-agencies/audits/2015/09/16/subway-service-diversions-maintenance-and-capital-projects-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … Covered by Medicare Part B (2010-S-50). Background Many of the State's Medicaid recipients are also eligible for … To determine the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… in Medicaid. For these children, the State establishes a “Daily Child Care Rate” (Daily Rate), which is the basis for Medicaid funding that the … children in their custody. For services not covered by the Daily Rate, health care providers bill Medicaid directly and …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… made in our audit report, Improper Managed Care Payments for Certain Medicaid Recipients (Report 2010-S-66). … which was issued on July 24, 2012, determined that, for the five years ended June 30, 2010, Medicaid made $15.6 … Department of Health: Improper Managed Care Payments for Certain Medicaid Recipients ( 2010-S-66 ) …
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followStatus of the Board-Approved Capital Plan for 2005-2011 (Follow-Up)
… of the Board-Approved Capital Plan for 2005-2011 (Report 2008-S-48). Background Our initial audit report, which was issued on October 23, 2008, examined the actions taken by the Thruway Authority … Status of the Board-Approved Capital Plan for 2005-2011 (2008-S-48) New York State Thruway Authority: Proposed Toll …
https://www.osc.ny.gov/state-agencies/audits/2013/06/27/status-board-approved-capital-plan-2005-2011-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… and retired State, participating local government, and school district employees, and their dependents. The Empire …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… of implementation of the 11 recommendations made in our initial audit report, Improper Medicaid Payments for Recipients in Hospice Care ( 2017-S-76 ). About the Program Hospice is a program … of copayments, deductibles, and coinsurance. We issued our initial audit report on December 11, 2018. The audit …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followMedicaid Program – Improper Medicaid Payments for Misclassified Patient Discharges
… failed to properly report correct patient discharge codes on inpatient claims. The audit covered the period from … inpatient stay, the hospital reports certain information on its claims, such as the patient’s diagnoses and services … because payments may vary significantly depending on whether a patient is transferred or discharged. For …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesBenefits Advisement Services for Individuals With Disabilities Seeking Employment
… a network of professional life coaches who are educated in public benefits and work incentives for individuals with …
https://www.osc.ny.gov/state-agencies/audits/2021/07/20/benefits-advisement-services-individuals-disabilities-seeking-employmentUse of Federal Funding for Election Technology and Security
… whether the Board of Elections utilized available funding from the 2018 Help America Vote Act Election Security Grant to enhance the security of the … whether the Board of Elections BOE utilized available funding from the 2018 Help America Vote Act Election Security …
https://www.osc.ny.gov/state-agencies/audits/2021/09/17/use-federal-funding-election-technology-and-securityUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
To determine whether UnitedHealthcare paid claims using reasonable and customary reimbursement rate schedules that did not correlate
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… in our initial audit report, Maximizing Drug Rebates for Health and Recovery Plans (Report 2017-S-61 ). About … appropriate steps to collect all available drug rebates for HARPs. The audit covered the period October 1, 2015 … We determined the Department failed to collect rebates for HARP-related drugs since the program’s inception. We …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/maximizing-drug-rebates-health-and-recovery-plans-followEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with … Empire’s contracts with member hospitals include rate schedules for the payment of inpatient and outpatient …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… paid for durable medical equipment beyond allowed rental limits, and whether the Medicaid program could achieve cost savings by implementation of a rental cap on oxygen equipment. The audit covered the period … items are available to Medicaid recipients on a monthly rental basis, subject to certain limits (or caps). A special …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsSelected Aspects of Accommodations for Passengers With Disabilities (Follow-Up)
… PANYNJ staff. Four of the PATH stations, in Manhattan (9th Street, 14th Street, 23rd Street, and Christopher Street) were not accessible for …
https://www.osc.ny.gov/state-agencies/audits/2023/05/12/selected-aspects-accommodations-passengers-disabilities-followAnnual Assessment of Market Orders for 2015 and 2016
… 2014 through June 30, 2016 for the Apple and Sour Cherry Market Orders and the period April 1, 2014 through March 31, … the Program During the audit period, the Department’s Market Order Administration was responsible for the administration of all farm product market orders, except those involving dairy products. Each …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/annual-assessment-market-orders-2015-and-2016Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services
… covered the period from January 1, 2014 through December 31, 2018. Background Mechanical ventilation is the use of a … Hospitals use International Classification of Diseases (ICD) procedure codes on their claims to report mechanical … ventilation services. When hospitals use a specific ICD procedure code to report a patient received 96 …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-servicesMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… To determine if the Department of Health overpaid health care providers’ Medicaid claims for services also covered by … in Medicare Part C, also known as Medicare Managed Care or Medicare Advantage. Under Medicare Part C, private managed care companies administer Medicare benefits and offer …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-services