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United HealthCare Insurance Company of New York – Empire Plan Drug Rebates (Follow-Up)
… made in our audit report, United HealthCare Insurance Company of New York: Empire Plan Drug Rebates … New York State Health Insurance Program: United HealthCare Insurance Company of New York - Empire Plan Drug Rebates ( … recommendations made in our audit report United HealthCare Insurance Company of New York Empire Plan Drug Rebates …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/united-healthcare-insurance-company-new-york-empire-plan-drug-rebates-followMedicaid Program – Medicaid Claims Processing Activity October 1, 2015 Through March 31, 2016
… clinic, durable medical equipment, transportation, and eye care services; $333,504 in improper payments identified … providers in the Medicaid program who were charged with or found guilty of crimes that violate health care programs’ laws or regulations. The Department terminated 14 of the providers …
https://www.osc.ny.gov/state-agencies/audits/2016/11/30/medicaid-program-medicaid-claims-processing-activity-october-1-2015-through-march-31-2016Facility Structure, Safety, and Health Code Waivers (Follow-Up)
… four recommendations included in our initial audit report, Facility Structure, Safety, and Health Code Waivers (Report … Department to grant waivers, temporary or permanent, to a facility to allow it to continue to operate while corrections … ascertain what waivers were in place at a given facility, nor could it identify the code violations that had …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/facility-structure-safety-and-health-code-waivers-followTrash Can Free Stations Pilot Program (Follow-Up)
… recommendations included in our initial report, Trash Can Free Stations Pilot Program (2014-S-29). Background Our … three recommendations included in our initial report Trash Can Free Stations Pilot Program 2014S29 …
https://www.osc.ny.gov/state-agencies/audits/2017/02/14/trash-can-free-stations-pilot-program-followAdministration of the Article 8-A Loan Program (Follow-Up)
… initial audit report, Administration of the Article 8-A Loan Program (Report 2013-N-4). Background Our initial audit … whether the loans awarded by HPD under the Article 8-A Loan Program (Program) were being used only for qualified projects and their intended purpose and whether loan recipients were complying with the requirements of their …
https://www.osc.ny.gov/state-agencies/audits/2017/04/12/administration-article-8-loan-program-followOversight of Homeless Shelters (Follow-Up)
… responsible for monitoring Local Districts’ oversight and inspection of uncertified shelters, and for ensuring they … provided to Local Districts in the areas of shelter inspection and the correction of deficiencies. Other Related …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-homeless-shelters-followImproper Payments to a Physical Therapist (Follow-Up)
… of the two recommendations included in our initial audit report, Improper Payments to a Physical Therapist ( Report 2013-S-15 ). Background The State’s Medicaid program … of the two recommendations included in our initial audit report Improper Payments to a Physical Therapist Report 201 …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followOverpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… for each newborn enrolled in the MCO. The MCO, in turn, is responsible for the provision of covered health care …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followExamination of Unemployment Insurance Willful Overpayments
… penalties in accordance with Federal and State law for unemployment insurance (UI) overpayments that resulted from claimants’ … benefits. Background UI benefits are temporary income for eligible workers who become unemployed through no fault … penalties in accordance with Federal and State law for unemployment insurance …
https://www.osc.ny.gov/state-agencies/audits/2018/09/25/examination-unemployment-insurance-willful-overpaymentsExamination of Travel Expenses
… continued to improperly designate the employee’s official station in calendar years 2015, 2016 and 2017. Background As … travel between an employee’s residence and official station is considered commuting and is not reimbursable. The official station of every employee is designated by the head of the …
https://www.osc.ny.gov/state-agencies/audits/2018/07/26/examination-travel-expensesMedicaid Claims Processing Activity October 1, 2011 Through March 31, 2012
… Purpose To determine whether the Department of Health's eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were processed in … To determine whether the Department of Healths eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers were …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-claims-processing-activity-october-1-2011-through-march-31-2012Medicaid Program – Medicaid Claims Processing Activity April 1, 2011 Through September 30, 2011
… ended September 30, 2011, eMedNY processed approximately 178 million claims resulting in payments to providers of …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-program-medicaid-claims-processing-activity-april-1-2011-through-september-30-2011Medicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
… Medicaid payments, including: $1,822,467 in payments for pharmacy claims that posed patient safety concerns or were … claims that providers billed at higher levels of care than what was actually provided; $1,005,176 in overpayments for … information pertaining to recipients’ other health insurance coverage; $666,992 in overpayments for claims …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013MTA-NYC Transit Medical Assessment Centers
… examinations and assessments are done at one of Transit’s five MAC locations. In addition, there is a 24-hour lab located in Downtown Brooklyn. Employees are assigned to a MAC according to their work location. If testing is needed, …
https://www.osc.ny.gov/state-agencies/audits/2014/11/10/mta-nyc-transit-medical-assessment-centersCollection and Use of Oil Spill Funds
… Laws of 1977 established the Oil Spill Fund to pay for the cleanup and removal of petroleum spills. The statute assigns … for the Fund as well as the duty to review and process all cleanup bills submitted for payment. The Department is … collects fees from PBS facilities and reimbursements of cleanup costs from spillers. During the two fiscal years …
https://www.osc.ny.gov/state-agencies/audits/2015/08/13/collection-and-use-oil-spill-fundsMedicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
… for which eMedNY did not properly factor Medicare coverage or a lower level of care into the payment; $682,022 in … billings and hospital, clinic, transportation, and eye care services. By the end of the audit fieldwork, … providers in the Medicaid program who were charged with or found guilty of crimes that violate health care programs’ …
https://www.osc.ny.gov/state-agencies/audits/2015/05/21/medicaid-program-medicaid-claims-processing-activity-october-1-2013-through-march-31-2014Housing Preferences for Disabled Veterans (Follow-Up)
… two recommendations included in our initial audit report, Housing Preference for Disabled Veterans (2010-S-42). Background In November 2007, the Private Housing Law was amended to require housing companies to provide disabled veterans with a … two recommendations included in our initial audit report Housing Preference for Disabled Veterans 2010S42 …
https://www.osc.ny.gov/state-agencies/audits/2013/02/19/housing-preferences-disabled-veterans-followMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… Purpose To determine whether the Department of Health paid pharmacy providers for controlled substances in compliance with the New York … supply. During the audit period, the Medicaid program paid pharmacy providers through the fee-for-service method and the … To determine whether the Department of Health paid pharmacy providers for controlled substances in compliance …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsQuality of Internal Control Certifications (Follow-Up)
… Purpose In 2012, we conducted a series of audits at 12 State agencies focusing specifically on their 2011-2012 … maintained documentation supporting the answers given. The 12 audits were performed at the following agencies: … quality of Internal Control Certifications at 10 of the 12 agencies. We found instances where Internal Control …
https://www.osc.ny.gov/state-agencies/audits/2015/07/07/quality-internal-control-certifications-followWage Theft Investigations (Follow-Up)
… reports that track information to monitor these plans and alert senior management to accounts in arrears. Other Related …
https://www.osc.ny.gov/state-agencies/audits/2015/05/22/wage-theft-investigations-follow