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Medicaid Drug Rebate Program Under Managed Care (Follow-Up)
… made in our initial audit report, Medicaid Drug Rebate Program Under Managed Care (Report 2014-S-41 ). Background The State’s Medicaid program provides a wide range of health care services to … made in our initial audit report Medicaid Drug Rebate Program Under Managed Care …
https://www.osc.ny.gov/state-agencies/audits/2017/06/30/medicaid-drug-rebate-program-under-managed-care-followEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member hospitals. Payments for hospital services are generally based on standard fee …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughAdoption Subsidy Program (Follow-Up)
… in compliance with governing regulations. The Office of Children and Family Services (OCFS) established the Adoption … alternative homes for hard-to-place and handicapped foster children. The Program, administered by local social services … assist adoptive parents in the care and support of these children. We found that payments were supported and were in …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/adoption-subsidy-program-followBenefit Eligibility Assessment Process
… the Office of Temporary and Disability Assistance's (OTDA) Fair Hearing process is used only as necessary. Background … resort, Clients deemed to be ineligible are entitled to a Fair Hearing administered by OTDA. OTDA's Fair Hearing Process costs taxpayers more than $32 million …
https://www.osc.ny.gov/state-agencies/audits/2014/05/28/benefit-eligibility-assessment-processPipeline Safety Oversight
… distribute natural gas and hazardous liquids, including crude oil, refined petroleum products, and other highly …
https://www.osc.ny.gov/state-agencies/audits/2016/03/08/pipeline-safety-oversightSelected Aspects of Inactive Hazardous Waste Site Remediation Cost Recovery
… State costs related to site investigation and remediation, bill for and collect these costs from responsible parties in … billing process and the timeliness of billing. However, bill preparation is a very time-consuming process and billing … which delays recovery of some State costs until the next bill is prepared. We reviewed 21 bills for eight sites and …
https://www.osc.ny.gov/state-agencies/audits/2015/01/22/selected-aspects-inactive-hazardous-waste-site-remediation-cost-recoveryAccounts Receivable Collection and Reporting
… The Authority’s mission is to advance innovative energy solutions in ways that improve New York's economy and environment by promoting energy efficiency and the use of renewable energy sources. … in October 2011 by the Public Service Commission for utility charges associated with its newly enacted Energy …
https://www.osc.ny.gov/state-agencies/audits/2015/08/05/accounts-receivable-collection-and-reportingMedicaid Program – Medicaid Drug Rebate Program Under Managed Care
… dispensed to individuals enrolled in Medicaid managed care. The audit covered the period from October 1, 2011 to … In 1990, Congress created the Medicaid Drug Rebate Program (Rebate Program) to reduce state and federal … requesting rebates from drug manufacturers. The Affordable Care Act, enacted in 2010, extended prescription drug rebates …
https://www.osc.ny.gov/state-agencies/audits/2015/02/18/medicaid-program-medicaid-drug-rebate-program-under-managed-careMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background Our initial … nursing home claims submitted to Medicaid for hospital bed reserve days were appropriate, and if not, to what extent nursing home claims exceeded the bed reserve day limits. During the five year audit period …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followOversight of Homeless Shelters
… Purpose To determine whether the Office of Temporary and Disability … Assistance (Office) adequately oversees homeless shelters to ensure they are operating in compliance with applicable … To determine whether the Office of Temporary and Disability …
https://www.osc.ny.gov/state-agencies/audits/2016/02/12/oversight-homeless-sheltersSelected Operating and Administrative Practices of the Bureau of Narcotic Enforcement (Follow-Up)
… and abuse in New York State, in large part through its analysis and use of prescription data that it maintains … deterrence to detection and prosecution. For example, our analysis of prescription data identified patterns of errors … for potential investigations; enhance routine data analysis; safeguard returned prescription forms; develop and …
https://www.osc.ny.gov/state-agencies/audits/2015/09/23/selected-operating-and-administrative-practices-bureau-narcotic-enforcement-followImproper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… for Pharmacy Services Covered by Managed Care (Report 2014-S-5 ). Background Our initial audit report, which was … Payments for Pharmacy Services Covered by Managed Care (2014-S-5) …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followControls Over Cash Advance Accounts (Follow-Up)
… Purpose To determine the extent of implementation of the eight recommendations included in our original report, Controls Over Cash Advance Accounts … To determine the extent of implementation of the eight recommendations included in our original report Controls Over Cash Advance Accounts …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/controls-over-cash-advance-accounts-followForensic Audit of Payments to On-Board Service Managers (Follow-Up)
… the Unit violated Metro-North policy by not disclosing the referral of a relative who was hired in the Unit. Key Finding …
https://www.osc.ny.gov/state-agencies/audits/2016/01/21/forensic-audit-payments-board-service-managers-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… Department of Transportation (Department) requirements for classifying, reporting and repairing bridge defects. … did not always comply with the Department’s requirement for an annual interim inspection if the repairs are not … 10 of the 17 Safety Conditions sampled were not repaired for more than two years, including three which were open for …
https://www.osc.ny.gov/state-agencies/audits/2016/06/30/inspecting-highway-bridges-and-repairing-defects-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
To determine the extent of implementation of 3 recommendations made in our audit report NYS Health Insurance Program Empire BlueCross BlueShield Selected Paym
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)
… recommendations made in our initial audit report, United HealthCare Insurance Company of New York: Empire Plan Drug … of Civil Service (Department) contracted with United HealthCare (United) to administer the Plan’s prescription … Interest New York State Health Insurance Program: United HealthCare: Payments for Fraudulent and Improper Claims …
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)
… we identified, formally assess the payments we did not test, and formally assess the conduct of William Davis. Key …
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
… Technology (IT) Transformation to consolidate and merge State agencies’ operations and streamline services. ITS … found that ITS is currently in its fourth year, and only one of these initiatives (Email Consolidation and …
https://www.osc.ny.gov/state-agencies/audits/2016/08/24/effectiveness-information-technology-transformationUse of State Appropriations
… (Foundation) has spent State funding in compliance with relevant statutory and contractual requirements, including … Foundation has spent State funding in compliance with relevant statutory and contractual requirements …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/use-state-appropriations