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Programs for Little Learners – Compliance With the Reimbursable Cost Manual
… whether the costs reported by Programs For Little Learners (PFLL) on its Consolidated Fiscal Reports (CFRs) … whether the costs reported by Programs For Little Learners on its Consolidated Fiscal Reports were properly …
https://www.osc.ny.gov/state-agencies/audits/2018/09/24/programs-little-learners-compliance-reimbursable-cost-manualYork College – Time and Attendance Practices for Public Safety Staff
… Purpose To determine whether York College had adequate controls over the time and attendance of Public Safety employees to provide reasonable assurance that they worked the hours … To determine whether York College had adequate controls over …
https://www.osc.ny.gov/state-agencies/audits/2015/04/06/york-college-time-and-attendance-practices-public-safety-staffOverpayments of Hospitals’ Claims for Lengthy Acute Care Admissions (Follow-Up)
… overpayments, formally notify hospitals of the correct way to bill inpatient claims for ALC, and modify IPRO’s … in our initial report, notified hospitals of the correct way to bill inpatient claims for ALC, and modified IPRO’s …
https://www.osc.ny.gov/state-agencies/audits/2015/07/07/overpayments-hospitals-claims-lengthy-acute-care-admissions-followUnited HealthCare – Overpayments for Services Provided by Dr. John Gomes
… Purpose To determine whether the practice of Dr. John Gomes routinely waived Empire Plan members’ … City, an obstetrics and gynecology practice operated by Dr. John Gomes, located on Franklin Avenue in Garden City, New York. With respect to the Empire Plan, Dr. Gomes’ practice is a non-participating provider. During …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-dr-john-gomesLeague for the Handicapped – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the League for the Handicapped (LFH) on its Consolidated … To determine whether the costs reported by the League for the Handicapped LFH on its Consolidated Fiscal …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/league-handicapped-compliance-reimbursable-cost-manualCrossroads Center for Children – Compliance With the Reimbursable Cost Manual
… determine whether the costs reported by Crossroads Center for Children, (Crossroads) on its Consolidated Fiscal Report … 30, 2014. Background Crossroads is an SED-approved, not-for-profit organization located in Schenectady, New York. … the ages of three and five years. Crossroads is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/crossroads-center-children-compliance-reimbursable-cost-manualCenter for Disability Services – Compliance With the Reimbursable Cost Manual
… (SED) guidelines, including the Reimbursable Cost Manual (Manual). Our audit covered the calendar year ended December … preschool special education program services through rates set by SED. These reimbursement rates are based on financial …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/center-disability-services-compliance-reimbursable-cost-manualUnnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)
… included in our initial audit report, Unnecessary Managed Care Payments for Medicaid Recipients With Medicare (Report … (Department) made premium payments to Medicaid managed care plans for Medicaid recipients who also had Medicare … we identified about 271,000 unnecessary Medicaid managed care payments (totaling about $111 million) that were made on …
https://www.osc.ny.gov/state-agencies/audits/2013/11/01/unnecessary-managed-care-payments-medicaid-recipients-medicare-followAnnual Assessment of Market Orders for 2012, 2013, and 2014
… of all farm product market orders, except those involving dairy products. Each specific market order detailed in …
https://www.osc.ny.gov/state-agencies/audits/2015/05/07/annual-assessment-market-orders-2012-2013-and-2014Medicaid Program – Overpayments for Services Also Covered by Medicare Part B
… (FQHCs). FQHCs are "safety net" organizations that receive enhanced reimbursements from Medicare and Medicaid because … designated them as FQHCs which made them eligible for enhanced Medicaid reimbursements they were not entitled to. …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-program-overpayments-services-also-covered-medicare-part-bMedicaid Program – Improper Managed Care Payments for Misclassified Patient Discharges
… 31, 2021. About the Program The State’s Medicaid program is administered by the Department of Health (Department). … care, whereby the Department pays MCOs a monthly premium for each enrolled recipient and, in turn, the MCOs arrange … Our review found: 47 claims were overpaid $323,531 because they were incorrectly coded as discharges when the patients …
https://www.osc.ny.gov/state-agencies/audits/2022/08/19/medicaid-program-improper-managed-care-payments-misclassified-patient-dischargesCompliance With Special Education Regulations for the Provision of Services
… Objective To determine if the New York City Department of Education (DOE) arranged for eligible students to be placed in special education … To determine if the New York City Department of Education DOE arranged for eligible students to be placed …
https://www.osc.ny.gov/state-agencies/audits/2020/09/30/compliance-special-education-regulations-provision-servicesImproper Fee-for-Service Payments for Services Covered by Managed Care (Follow-Up)
… Fee-for-Service Payments for Services Covered by Managed Care (Report 2017-S-74 ). About the Program The Department of … providers using the fee-for-service (FFS) or managed care method. Under the FFS method, the Department, through … rendered to Medicaid recipients. Under the managed care method, the Department pays managed care plans a monthly …
https://www.osc.ny.gov/state-agencies/audits/2021/02/11/improper-fee-service-payments-services-covered-managed-care-followSelected Aspects of Collecting Outstanding Amounts Due for Parking Violations
… (DOF) identifies and collects fines and fees that are due for parking violations. This audit covered 262,765 cases with … February 1, 2019. About the Program DOF is responsible for collecting and processing payments for parking fines for the approximately 30 entities that can …
https://www.osc.ny.gov/state-agencies/audits/2021/03/23/selected-aspects-collecting-outstanding-amounts-due-parking-violationsImproper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (Follow-Up)
… of an individual’s health, inadequate treatment or neglect, or from the treatment of another condition. Once malnutrition …
https://www.osc.ny.gov/state-agencies/audits/2020/09/02/improper-medicaid-payments-recipients-diagnosed-severe-malnutrition-followMedicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services (Follow-Up)
… 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 … we identified; remind hospitals to use the proper ICD procedure code that represents the duration of time the …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-services-followEmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits
… To determine whether EmblemHealth Plan, Inc. overpaid dental claims for members covered by two subscriber plans under the New York State Dental Insurance Program. The audit covered the period from … To determine whether EmblemHealth Plan Inc overpaid dental claims for members covered by two subscriber plans …
https://www.osc.ny.gov/state-agencies/audits/2024/01/08/emblemhealth-plan-inc-overpayments-services-requiring-coordination-benefitsApplication Review and Site Permitting for Major Renewable Energy Projects
… to site major renewable energy projects and bring them online faster in support of the Climate Act’s ambitious goals …
https://www.osc.ny.gov/state-agencies/audits/2024/04/24/application-review-and-site-permitting-major-renewable-energy-projectsCantalician Center for Learning – Compliance With the Reimbursable Cost Manual
… determine whether the costs reported by Cantalician Center for Learning (Cantalician) on its Consolidated Fiscal Reports … submitted by Cantalician to SED on its 2016 and 2017 CFRs for the fiscal year ended June 30, 2017. About the Program Cantalician is an SED-approved, not-for-profit special education provider located in Depew, …
https://www.osc.ny.gov/state-agencies/audits/2023/01/26/cantalician-center-learning-compliance-reimbursable-cost-manualImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… objective of our initial audit report, issued November 29, 2021, was to determine if Medicaid made improper Medicare … enrolled in the Buy-in Program for the period from January 1, 2015 through December 31, 2019 and associated Medicare Buy-in Program …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-follow