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United HealthCare Insurance Company of New York – Empire Plan Drug Rebates (Follow-Up)
… of the administration of the prescription drug program to Medco Health Solutions, Inc. (Medco), including the negotiation and collection of rebates … Express Scripts Holding Company (Express Scripts) acquired Medco. Our initial audit report, issued on December 28, 2015, …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/united-healthcare-insurance-company-new-york-empire-plan-drug-rebates-followMedicaid Program – Medicaid Claims Processing Activity October 1, 2015 Through March 31, 2016
… system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for their claims. During the six-month period ended March 31, … Medicaid payments, as follows: $3,521,562 in overpayments for fee-for-service claims for recipients whose services were …
https://www.osc.ny.gov/state-agencies/audits/2016/11/30/medicaid-program-medicaid-claims-processing-activity-october-1-2015-through-march-31-2016Facility Structure, Safety, and Health Code Waivers (Follow-Up)
… Purpose To determine the extent of implementation of the four recommendations included in our initial audit … To determine the extent of implementation of the four recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/facility-structure-safety-and-health-code-waivers-followAdministration of the Article 8-A Loan Program (Follow-Up)
… Article 8-A Loan Program (Program) were being used only for qualified projects and their intended purpose and whether loan recipients were … reduced interest rates assigned to some of these owners are not supported. We determined that over time, these …
https://www.osc.ny.gov/state-agencies/audits/2017/04/12/administration-article-8-loan-program-followOversight of Homeless Shelters (Follow-Up)
… and codes. Key Findings Since our initial audit, general conditions and habitability at shelters have improved. Of the … were not as severe or numerous; however, unacceptable conditions still exist and, importantly, can develop quickly. … steps, we believe continued improvement of shelter conditions can be realized with more guidance and support …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-homeless-shelters-followImproper Payments to a Physical Therapist (Follow-Up)
… Purpose To determine the extent of implementation of the two recommendations included in our initial audit … To determine the extent of implementation of the two recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followOverpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Report 2013-S-57). Background The … care. For example, MCOs receive a “Supplemental Low Birth Weight Newborn Capitation Payment” (low birth weight kick payment) for each enrolled newborn weighing …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followExamination of Unemployment Insurance Willful Overpayments
… at $4,022 that were under-assessed by NYDOL. In addition, staff recorded 6,405 overpayments incorrectly, but these … errors were caused by either NYDOL officials providing staff with unwritten agency policy that was contrary to law, or staff not following established procedures. Key …
https://www.osc.ny.gov/state-agencies/audits/2018/09/25/examination-unemployment-insurance-willful-overpaymentsExamination of Travel Expenses
… Purpose This is a continuation of our examination detailed in Report … between an employee’s residence and official station is considered commuting and is not reimbursable. The official station of every employee … This is a continuation of our examination detailed in Report …
https://www.osc.ny.gov/state-agencies/audits/2018/07/26/examination-travel-expensesMedicaid Claims Processing Activity October 1, 2011 Through March 31, 2012
To determine whether the Department of Healths eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers were processed in ac
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-claims-processing-activity-october-1-2011-through-march-31-2012Medicaid Program – Medicaid Claims Processing Activity April 1, 2011 Through September 30, 2011
… Purpose To determine whether the Department of Health's eMedNY system reasonably ensured that Medicaid … 2011 through September 30, 2011. Background The Department of Health (Department) administers the State's Medicaid … 178 million claims resulting in payments to providers of about $25 billion. The claims are processed and paid in …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-program-medicaid-claims-processing-activity-april-1-2011-through-september-30-2011Medicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
… Purpose To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … Medicaid requirements, and resulted in correct payments to the providers. The audit covered the period April 1, 2013 … To determine whether the Department of Healths eMedNY system reasonably ensured …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013MTA-NYC Transit Medical Assessment Centers
… Purpose To determine whether the MTA-NYC Transit Medical Assessment Centers performed medical examinations for NYC Transit and MTA Bus employees in … To determine whether the MTANYC Transit Medical Assessment Centers performed medical examinations for …
https://www.osc.ny.gov/state-agencies/audits/2014/11/10/mta-nyc-transit-medical-assessment-centersCollection and Use of Oil Spill Funds
… the Oil Spill Fund to pay for the cleanup and removal of petroleum spills. The statute assigns the State Comptroller … registering, and collecting appropriate fees from petroleum storage facilities. Facilities with a total petroleum storage capacity of less than 400,000 gallons are …
https://www.osc.ny.gov/state-agencies/audits/2015/08/13/collection-and-use-oil-spill-fundsMedicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
… coverage that recipients had; $112,981 in overpayments for nursing home claims for which eMedNY did not correctly deduct … improper payments for duplicate billings and hospital, clinic, transportation, and eye care services. By the end of …
https://www.osc.ny.gov/state-agencies/audits/2015/05/21/medicaid-program-medicaid-claims-processing-activity-october-1-2013-through-march-31-2014Housing Preferences for Disabled Veterans (Follow-Up)
… Purpose To determine the extent of implementation of the two recommendations included in our initial audit … To determine the extent of implementation of the two recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2013/02/19/housing-preferences-disabled-veterans-followMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… Purpose To determine whether the Department of Health paid pharmacy providers for controlled substances in compliance … supply. During the audit period, the Medicaid program paid pharmacy providers through the fee-for-service method and the … managed care method. Under fee-for-service, Medicaid pays pharmacy providers directly for drugs dispensed to Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsQuality of Internal Control Certifications (Follow-Up)
… answered all the questions with the appropriate level of detail, and maintained documentation supporting the answers … to the quality of Internal Control Certifications at 10 of the 12 agencies. We found instances where Internal … timely and/or did not provide the appropriate level of detail, as well as cases where agencies were unable to …
https://www.osc.ny.gov/state-agencies/audits/2015/07/07/quality-internal-control-certifications-followWage Theft Investigations (Follow-Up)
… payment. Of these, 12,938 cases (75 percent) had been open more than one year since the initial claim was received. … this follow up, the Division only had 305 cases that were open for more than one year. This was accomplished primarily …
https://www.osc.ny.gov/state-agencies/audits/2015/05/22/wage-theft-investigations-followOversight of Procurements and Loan Programs
… DANC’s operations provide services to customers at Fort Drum and in surrounding counties. DANC has partnered with an …
https://www.osc.ny.gov/state-agencies/audits/2015/08/04/oversight-procurements-and-loan-programs