Search
Unnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations made in our audit report, … To determine the extent of implementation of the five recommendations made in our …
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)
… of the five recommendations made in our audit report, Improper Managed Care Payments for Certain Medicaid … years ended June 30, 2010, Medicaid made $15.6 million in improper managed care payments on behalf of 14,899 recipients … that the Department investigate the $15.6 million in improper Medicaid managed care payments and strengthen …
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)
… Purpose To determine the extent of implementation of the five recommendations included in our initial report, … To determine the extent of implementation of the five recommendations included in our …
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 recovery of overpayments made to hospitals for special medical items; and took sufficient steps to … The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The Empire … with member hospitals include reimbursement rate schedules for the payment of inpatient and outpatient hospital …
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)
… Objective To determine the extent of implementation of the 11 recommendations made in our initial audit report, … To determine the extent of implementation of the 11 recommendations made in our …
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
… Objective To determine whether the Medicaid program made inappropriate fee-for-service (FFS) … correct patient discharge codes on inpatient claims. The audit covered the period from January 1, 2015 to December 31, 2019. About … To determine whether the Medicaid program made inappropriate feeforservice …
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
… Yorkers with disabilities are more than twice as likely to live in poverty. The New York State Employment First …
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
… available funding from the 2018 Help America Vote Act Election Security Grant to enhance the security of the State’s election technology and infrastructure. The audit covered the … available funding from the 2018 Help America Vote Act Election Security Grant to enhance the security of the States …
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
… UnitedHealthcare (United) paid claims using reasonable and customary (R&C) reimbursement rate schedules that did not correlate with the date of the service on the claims, and to calculate the corresponding financial impact. The … health insurance coverage to over 1.2 million active and retired State, local government and school district …
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)
… Objective To determine the extent of implementation of the two recommendations made in our initial audit report, … Health and Recovery Plans (Report 2017-S-61 ). About the Program In 1990, Congress created the Medicaid Drug … To determine the extent of implementation of the two recommendations made …
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)
… in our initial audit report, Controls Over Payments for Special Items (Report 2016-S-57 ). About the Program The … The Empire Plan is the primary health benefits plan for NYSHIP. Empire BlueCross (Empire) administers the … portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates …
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)
… identify key stations in its Port Authority Trans-Hudson (PATH) system and make those stations accessible and usable by … and Rehabilitation Act of 1973 that we reviewed within the PATH system and at the three bus terminals operated by … to seek assistance from PANYNJ staff. Four of the PATH stations, in Manhattan (9th Street, 14th Street, 23rd …
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
… was responsible for the administration of all farm product market orders, except those involving dairy products. Each specific market order is established in …
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
… ventilation, it may cause Medicaid’s payment to the hospital to increase. For the period of January 1, 2014 …
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
… Background Many Medicaid recipients are also enrolled in Medicare Part C, also known as Medicare Managed Care or … Plan. We sampled 266 such claims (totaling $220,661 in Medicaid payments) to determine the appropriateness of the …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations included in our initial audit … To determine the extent of implementation of the five recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-followImplementation of the Dignity for All Students Act (Follow-Up)
… Objective To determine the extent of implementation of the three recommendations included in our initial audit … To determine the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2019/11/21/implementation-dignity-all-students-act-followBrighter Choice Charter School for Boys - Payroll (2018M-139)
… Determine whether internal controls were in place to ensure that employee compensation was accurate, supported … officials effectively designed and implemented procedures to ensure that compensation payments were accurate, and … We reviewed the gross pay calculations of these employees to determine whether salaries and pay rates were authorized, …
https://www.osc.ny.gov/local-government/audits/charter-school/2018/10/12/brighter-choice-charter-school-boys-payroll-2018m-139Medicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… to providers who reported claims with a PR 45 cost-sharing amount. The audit covered the period from December 2020 … the reason for any adjustments made to the claim amount. Claim Adjustment Reason Codes (CARCs) and group codes … to providers who reported claims with a PR 45 costsharing amount …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claims