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League for the Handicapped – Compliance With the Reimbursable Cost Manual
… Audits/Reports of Interest State Education Department: Summit Educational Resources - Compliance With the …
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
… Cost Manual (2015-S-48) State Education Department: Story Place Preschool Inc. – Compliance With the …
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
… not-for-profit special education provider located in Albany, New York. CFDS provides preschool special … services to children with disabilities between the ages of three and five years. CFDS is reimbursed for preschool … ended December 31, 2013, CFDS reported about $4.8 million in reimbursable costs on its CFR for five preschool special …
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)
… of implementation of the six recommendations included in our initial audit report, Unnecessary Managed Care … Medicare deductibles and coinsurance for the recipients in question, the net savings to Medicaid would have been … Medicaid managed care premiums occurred because of delays in posting recipients' Medicare data to eMedNY (Medicaid's …
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
… that the Comptroller audit the expenditures for each market order. Our audit covered the period July 1, 2011 through June 30, 2014 for the Apple and Sour Cherry Market Orders and the period April 1, 2011 through March 31, … Programs. Background Within the Department, the Market Order Administration unit is responsible for …
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
… health care providers for Medicaid claims for Medicare Part B coinsurance. The audit covers the period January 1, … and disabled. It consists of several parts. Medicare Part B helps pay for medical care provided in outpatient … Medicare pays 80 percent of the charges for approved Part B services, and Medicaid pays the remaining balances …
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
… (Department). Many Medicaid recipients receive their medical services through managed care, whereby the Department pays MCOs a monthly premium for each enrolled recipient and, in turn, the MCOs arrange … claims totaling $32.3 million for Medicaid recipients who were reported as discharged from a hospital but then …
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
… To determine if the New York City Department of Education (DOE) arranged for eligible students to be placed in special … students in special education. In New York City (NYC), the DOE is responsible for determining eligibility for and … such students. Specifically, the Regulations require that DOE arrange for the placement of eligible students in special …
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
… that were issued to vehicles for parking, red light camera, bus lane camera, and school zone camera violations. DOF’s responsibilities include generating …
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)
… the appropriate International Classification of Diseases (ICD) code on its Medicaid claim to reflect the diagnosis. …
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
… of Civil Service contracts with EmblemHealth Plan, Inc. (Emblem) to process and pay claims for services on behalf of … coverage (referred to as subscriber plans), making Emblem both the primary and secondary payer. For instance, in … and as a dependent on their spouse’s subscriber plan. With Emblem as both the primary and secondary payer for each …
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
… its obligations under State law to issue siting permits for major renewable energy projects within the required time … goals of the Climate Act strive to improve quality of life for New Yorkers, protect the environment, and strengthen … allowed to transfer their project applications to ORES for review. ORES has 60 days to determine whether a permit …
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
… not-for-profit special education provider located in Depew, serving students from Erie, Genesee, and Niagara … to children with disabilities who are between the ages of 3 and 5 years. Cantalician is reimbursed for these … 30, 2017, Cantalician reported approximately $2.23 million in reimbursable costs on its CFRs for two rate-based special …
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)
… (Report 2020-S-35 ). About the Program The Department of Health (Department) administers New York’s Medicaid program. … 2021, was to determine if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in the … December 31, 2019 and associated Medicare Buy-in Program credits from January 1, 2015 to November 30, 2020. We …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followUse of Federal Funding for Election Technology and Security (Follow-Up)
… Objective To determine the extent of implementation of the one recommendation included in our initial audit report, Use … the issues we identified, having implemented the one recommendation contained in our initial report. … To determine the extent of implementation of the one recommendation included in our initial audit report Use …
https://www.osc.ny.gov/state-agencies/audits/2023/06/22/use-federal-funding-election-technology-and-security-followBenefits Advisement Services for Individuals With Disabilities Seeking Employment (Follow-Up)
… disabilities in New York State in 2021. The employment rate of working-age people with disabilities was about 37% … with disabilities are more than twice as likely to live in poverty. The New York State Employment First Commission … with disabilities by 5% while also decreasing their poverty rate by 5%. One way the Report recommended this be …
https://www.osc.ny.gov/state-agencies/audits/2023/06/22/benefits-advisement-services-individuals-disabilities-seeking-employment-followQueens Centers for Progress – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Queens Centers for Progress (QCP) on its Consolidated Fiscal … To determine whether the costs reported by Queens Centers for Progress QCP on its Consolidated Fiscal …
https://www.osc.ny.gov/state-agencies/audits/2023/08/10/queens-centers-progress-compliance-reimbursable-cost-manualUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… To determine whether UnitedHealthcare Insurance Company of New York appropriately reimbursed physician-administered … Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance … Service contracts with UnitedHealthcare Insurance Company of New York (United) to administer the Medical/Surgical …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugs