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Empire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers (Follow-Up)
… Objective To determine the extent of implementation of the two recommendations included in our initial audit report, … dependents. NYSHIP’s primary health benefit plan is the Empire Plan. UnitedHealthcare (United) administers the …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatorySelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… BlueCross BlueShield’s (Empire’s) payments to Arden Hill Hospital (Arden Hill) for special items were made according … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-arden-hill-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to Stony Brook University Hospital from January 1, 2011 through March 31, 2011
… including Stony Brook. Empire's payments to Stony Brook are generally based on standard fee schedules. However, Stony … for certain special items (such as implants, drugs, and blood) that are not covered by the standard fee schedules. Per Empire's …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-stony-brook-university-hospital-january-1-2011-throughCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service
… Objective To determine if CVS Health remitted commercial drug rebate revenue related to Empire Plan drug utilization in accordance with its contract with the Department of Civil … 31, 2018. About the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of …
https://www.osc.ny.gov/state-agencies/audits/2020/08/21/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-serviceTravel/Conference Claim Requirements – Travel and Conference Expense Management
… employee has returned from his or her travel, an itemized claim or voucher 8 must be submitted for audit. The claim should be submitted in a timely manner and include … Cross-references to other claims if the total travel claim is spread among multiple vouchers. For example, a …
https://www.osc.ny.gov/local-government/publications/travel-conference-expense/travelconference-claim-requirementsTuckahoe Common School District - Extra-Classroom Activity (ECA) Funds (2018M-229)
… purposes. Key Findings The Board did not appoint a faculty counselor, faculty auditor or a central treasurer as … proper approvals. Key Recommendations Appoint a faculty counselor, auditor and central treasurer. Ensure that clubs …
https://www.osc.ny.gov/local-government/audits/school-district/2019/01/25/tuckahoe-common-school-district-extra-classroom-activity-eca-funds-2018mPulaski Academy and Central School District - Separation Payments (2020M-20)
Assess whether separation payments to certain District officials were authorized and accurately calculated in accordance with Board-approved employment contract
https://www.osc.ny.gov/files/local-government/audits/pdf/pulaski-academy-2020-20.pdfAusable Valley Central School District - Claims Auditing (2018M-190)
… whether claims were supported by adequate documentation, for appropriate purposes and audited and approved before … audited and approved the claims. Claims totaling $27,888 for 15 check disbursements made during the audit period were … whether claims were supported by adequate documentation for appropriate purposes and audited and approved before …
https://www.osc.ny.gov/local-government/audits/school-district/2019/01/25/ausable-valley-central-school-district-claims-auditing-2018m-190Harrisville Central School District – Transportation State Aid and Debt for Bus Purchases (2020M-48)
Determine whether the District applied for all transportation State aid for new bus acquisitions.
https://www.osc.ny.gov/files/local-government/audits/pdf/harrisville-2020-48.pdfPine Plains Central School District - Internal Controls Over Select Financial Activities (2018M-52)
… ensure that interim financial reports are reviewed to detect errors in preparation. … Pine Plains Central School …
https://www.osc.ny.gov/local-government/audits/school-district/2018/06/29/pine-plains-central-school-district-internal-controls-over-selectOpinion 97-22
… This opinion represents the views of the Office of the State Comptroller at the time it was … construction) COUNTIES -- Powers and Duties (financing the cost of community college dormitory) EDUCATION LAW, §§6304, … or lease, real or personal property suitable for carrying out the program and purposes of the college (Education Law, …
https://www.osc.ny.gov/legal-opinions/opinion-97-22Cheektowaga-Sloan Union Free School District – Financial Condition and Payroll (2017M-94)
The audit was to review District financial and payroll records for the period July 1, 2015 through March 2, 2017.
https://www.osc.ny.gov/files/local-government/audits/pdf/lgsa-audit-school-2017-cheektowaga-sloan.pdfUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… Purpose To determine if Davis Ethical Pharmacy inappropriately billed United HealthCare for prescription medications under the State's employee health insurance … and includes prescription drug coverage. The Department of Civil Service (Department) contracts with United …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyOpinion 2010-2
… views if, among other things, there have been subsequent court cases or statutory amendments that bear on the issues … of (procedures for selling unneeded vehicles by town water district) WATER DISTRICTS -- Property (sale of unneeded … Town Law §§ 198 (12) (a) nor 215 (8), nor any other statute, however, requires that the sale or lease of such …
https://www.osc.ny.gov/legal-opinions/opinion-2010-2Margaretville Central School District – Financial Management (2020M-46)
… - pdf ] Audit Objective Determine whether the Board and District officials effectively managed fund balance. Key … beneficial to taxpayers. … Determine whether the Board and District officials effectively managed fund balance …
https://www.osc.ny.gov/local-government/audits/school-district/2020/06/26/margaretville-central-school-district-financial-management-2020m-46Schodack Central School District - Extra-Classroom Activities (2019M-85)
… records showing all collections, disbursements and a running cash balance. District officials generally agreed …
https://www.osc.ny.gov/local-government/audits/school-district/2019/06/21/schodack-central-school-district-extra-classroom-activities-2019m-85Westhampton Beach Union Free School District – Extra-Classroom Activity Funds (2021M-9)
Determine whether Westhampton Beach Union Free School District’s (District’s) clubs properly accounted for, supported, deposited and used extra-classroom activity (ECA) funds.
https://www.osc.ny.gov/files/local-government/audits/2021/pdf/westhampton-beach-2021-9.pdfCVS Health – Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil Service
… Service for prescription drugs provided under the Empire Plan Medicare Rx drug benefit. Our audit covered the period …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/cvs-health-accuracy-empire-plan-medicare-rx-drug-rebate-revenue-remitted-department-civilUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… claims using reasonable and customary (R&C) reimbursement rate schedules that did not correlate with the date of the … claims is 80 percent of the R&C rate for the service. R&C rates are updated every six months. From January 1, 2017 … a sample of 100 claims, we calculated a potential cost savings of $214,008 for 84 claims that were paid using an R&C …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claims