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Medicaid Program – Medicaid Claims Processing Activity April 1, 2014 Through September 30, 2014
… The Department of Health (Department) administers the State’s Medicaid program. The Department’s eMedNY computer system processes Medicaid claims submitted by providers for services … Auditors also identified providers in the Medicaid program who were charged with or found guilty of crimes that violate …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014Improper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… of 14,899 recipients who, by State law, were precluded from enrollment in managed care programs. We recommended that …
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… procedures in place to ensure proper Medicaid payments for foster care children placed in voluntary agencies. The Department … administers the New York State Medicaid program. Many foster care children who are placed in private welfare …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followManagement and Control of Employee Overtime Costs (Follow-Up)
… included in our initial audit report, Management and Control of Employee Overtime Costs ( 2009-S-87 ). … 17, 2011, determined that the Port Authority of New York and New Jersey (Port Authority) generally did not effectively manage and control employee overtime costs and we noted numerous …
https://www.osc.ny.gov/state-agencies/audits/2014/12/19/management-and-control-employee-overtime-costs-followMedicaid Payments for Medicare Part A Beneficiaries (Follow-Up)
… made in our audit report, Medicaid Payments for Medicare Part A Beneficiaries (2009-S-36). Background Our … 20, 2010, examined whether Medicaid made overpayments for recipients who were also enrolled in Medicare Part A. … Medicare Part A provides supplementary medical insurance for inpatient care in hospitals, post-hospital nursing home …
https://www.osc.ny.gov/state-agencies/audits/2014/04/04/medicaid-payments-medicare-part-beneficiaries-followUnnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)
… on April 18, 2012, examined whether the Department of Health (Department) made premium payments to Medicaid managed … recipients' Medicare data to eMedNY (Medicaid's automated claims processing and payment system) and because recipients were not removed timely from the managed care plans once their Medicare data …
https://www.osc.ny.gov/state-agencies/audits/2013/11/01/unnecessary-managed-care-payments-medicaid-recipients-medicare-followContract with EBSCO Subscription Services, Inc. (Follow-Up)
… audit report Contract with EBSCO Subscription Services Inc Re …
https://www.osc.ny.gov/state-agencies/audits/2013/05/13/contract-ebsco-subscription-services-inc-followMedicaid Payments for Excessive Dental Services (Follow-Up)
… our initial audit report, Medicaid Payments for Excessive Dental Services (Report 2009-S-46). Background Our initial … on August 16, 2010, examined Medicaid payments for routine dental services, such as cleanings and oral evaluations, … 31, 2009. Our audit identified $40 million of excessive dental services that exceeded certain frequency limits (i.e., …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/medicaid-payments-excessive-dental-services-followOverpayments of Certain Medicare Crossover Claims (Follow-Up)
… extent of implementation of the five recommendations made in our audit report, Overpayments of Certain Medicare … Background Many Medicaid recipients are also enrolled in Medicare, the federal health care program for people 65 … years old with certain disabilities. Individuals enrolled in both programs are referred to as “dual-eligibles.” …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followInappropriate Medicaid Payments for Recipients With Multiple Identification Numbers and No Social Security Numbers (Follow-Up)
… Payments for Recipients with Multiple Identification Numbers and No Social Security Numbers (2010-S-29). Background Our initial audit report, which was issued on July 24, 2012, examined whether the Department of Health …
https://www.osc.ny.gov/state-agencies/audits/2014/08/06/inappropriate-medicaid-payments-recipients-multiple-identification-numbers-and-no-socialManagement of General School Funds (Follow-Up)
… of Education: Management of General School Funds (2013-F-33) …
https://www.osc.ny.gov/state-agencies/audits/2014/09/30/management-general-school-funds-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… included in our initial audit report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of the State's … Generally, Medicare is the primary payer of claims for services provided to dual-eligible recipients. After … included in our initial audit report Overpayments for Services Also Covered by Medicare …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… scaling and root planing for the treatment of periodontal disease. Scaling involves the removal of tartar, plaque, and … are covered by GHI for the treatment of periodontal disease, and according to GHI's policies, they are not … in nature. Instead, they are used when periodontal disease is indicated. The objective of the treatment is to …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followOverpayments to Cabrini Medical Center (Follow-Up)
… in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit covered the … to Medicaid. In these instances, the original claim was correct and should not have been adjusted and resubmitted. …
https://www.osc.ny.gov/state-agencies/audits/2013/11/07/overpayments-cabrini-medical-center-followVehicle and Heavy Equipment Purchase Program (Follow-Up)
… recommendations included in our initial audit report, Vehicle and Heavy Equipment Purchase Program ( Report … In addition, the Port Authority included funds for vehicle and equipment rentals in its annual Purchase Program. … Audit/Report of Interest Long Island Power Authority: Vehicle Acquisition, Use, and Disposition (2006-S-114) …
https://www.osc.ny.gov/state-agencies/audits/2014/11/03/vehicle-and-heavy-equipment-purchase-program-followState Agencies Bulletin No. 861
… Members who serve only part of the year but are Active on December 31, 2008 are also eligible for a year-end adjustment … who serve all or part of the year and are Active on December 31, 2008 are eligible for a year-end adjustment, … amount of regular earnings received for earnings dates December 27, 2007 through December 10, 2008 and the statutory …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/861-2008-year-end-adjustment-members-nys-legislatureMedicaid Program – Medicaid Claims Processing Activity October 1, 2012 Through March 31, 2013
… claims resulting in payments to providers of about $26 billion. The claims are processed and paid in weekly … for claims for a dialysis drug billed at 10 times the number of units actually provided; and Claims with improper … of the overpayments identified. Auditors also identified 26 providers in the Medicaid program who had been charged …
https://www.osc.ny.gov/state-agencies/audits/2014/05/22/medicaid-program-medicaid-claims-processing-activity-october-1-2012-through-march-31-2013Improper Overlapping Medicaid and Essential Plan Enrollments (Follow-Up)
… (Report 2020-S-66 ). About the Program DOH administers the State’s Medicaid program and the Essential Plan. Medicaid … may transition between Medicaid and the Essential Plan. NY State of Health (NYSOH) is the State-run health plan marketplace organized under DOH where …
https://www.osc.ny.gov/state-agencies/audits/2024/04/10/improper-overlapping-medicaid-and-essential-plan-enrollments-followDiNapoli: As State Tax Check-Off Options Increase, Spending Lags for Most
… New York state has the highest number of personal income tax (PIT) check-offs in the nation, but an analysis by … each year. “New York state offers many worthy causes for income tax filers to donate to on their income tax forms, but money from less than one-third of the …
https://www.osc.ny.gov/press/releases/2024/01/dinapoli-state-tax-check-off-options-increase-spending-lags-mostPurchasing and Procurement Practices (Follow-Up)
… three major thoroughbred racetracks: Aqueduct Racetrack, Belmont Park, and Saratoga Race Course. In September 2008, …
https://www.osc.ny.gov/state-agencies/audits/2024/01/18/purchasing-and-procurement-practices-follow