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Medicaid Program – Medicaid Claims Processing Activity April 1, 2014 Through September 30, 2014
… audit found: $31.4 million in potential overpayments for clinic claims that were processed using an incorrect pricing … improper payments for HIV tests, duplicate billings, and clinic, practitioner, and health home services. By the end of …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014American Academy of Pediatrics, District II
… C018189 and C022937. We sought to determine whether the expenses were bona fide and made in accordance with the … AAP approximately $1.5 million under these contracts for expenses related to various immunization initiatives. Key … Medical Education (CME) credits, program materials, hotel expenses, fringe benefits allegedly paid to the Executive …
https://www.osc.ny.gov/state-agencies/audits/2014/02/28/american-academy-pediatrics-district-iiEnhanced Medicaid Payments to Selected Home Health Care Service Providers (Follow-Up)
… audit report, Enhanced Medicaid Payments to Selected Home Health Care Service Providers (Report 2009-S-25). … issued on September 24, 2010, examined whether selected home health care providers properly used Medicaid funds for … 2006 through 2011, to organizations that provide certain home health care services to Medicaid recipients. The …
https://www.osc.ny.gov/state-agencies/audits/2013/09/05/enhanced-medicaid-payments-selected-home-health-care-service-providers-followEmpire BlueCross BlueShield – Payments to John T. Mather Memorial Hospital (Follow-Up)
… New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments to John T. Mather Memorial Hospital … New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments Made to Hudson Valley Hospital Center … New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments Made for Special Items to Selected …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/empire-bluecross-blueshield-payments-john-t-mather-memorial-hospital-followOverpayments of Claims for Selected Professional Services (Follow-Up)
… selected professional services such as podiatry, physical therapy, and occupational therapy during the calendar years 2010 and 2011. In each …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followContract with Daytop Village, Inc. (Follow-Up)
… Purpose To determine the extent of implementation of the three … OASAS paid Daytop $11.5 million more than it was entitled to. The objective of our follow-up was to assess the extent of implementation, as of October 2012, … To determine the extent of implementation of the three …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/contract-daytop-village-inc-followFood Safety Monitoring
… of Food Safety and Inspection (Division) is responsible for enforcing State laws and Department regulations related … As of June 4, 2013, the Division was responsible for inspecting 31,401 establishments. From April 1, 2011 … June 4, 2013, it received 5,724 consumer complaints for investigation, and inspectors obtained 3,894 food samples …
https://www.osc.ny.gov/state-agencies/audits/2014/01/30/food-safety-monitoringSelected Aspects of Bus Fleet Maintenance Report (Follow-Up)
… included in our initial audit report, Selected Aspects of Bus Fleet Maintenance (Report 2009-S-51). Background Our … has standards and procedures for the maintenance of its bus fleet, (2) performs bus maintenance in compliance with these standards and … included in our initial audit report Selected Aspects of Bus Fleet Maintenance Report 2009 …
https://www.osc.ny.gov/state-agencies/audits/2013/07/11/selected-aspects-bus-fleet-maintenance-report-followSelected Aspects of Railcar Fleet Maintenance (Follow-Up)
… Selected Aspects of Railcar Fleet Maintenance (Report 2009-S-68). Background Our initial audit report, which was issued … (MTA)-New York City Transit (Transit) and the MTA-Staten Island Railway (Railway) have established systems of … - Selected Aspects of Railcar Fleet Maintenance (2009-S-68) …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/selected-aspects-railcar-fleet-maintenance-followMedicaid Program – Medicaid Claims Processing Activity October 1, 2012 Through March 31, 2013
… 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, … payments, including: $6,329,458 in questionable payments for claims that were not subjected to the appropriate edits …
https://www.osc.ny.gov/state-agencies/audits/2014/05/22/medicaid-program-medicaid-claims-processing-activity-october-1-2012-through-march-31-2013Medicaid Claims Processing Activity April 1, 2012 Through September 30, 2012
… Claims with incorrect billings for alternate levels of care, which caused $465,313 in overpayments; Claims for dental services that should have been covered by a managed care plan, which caused $336,780 in overpayments; and Claims …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/medicaid-claims-processing-activity-april-1-2012-through-september-30-2012Management of Invasive Species (Follow-Up)
… invasive species (TIS). AIS are commonly spread via fishing and boating activities. The Department is authorized …
https://www.osc.ny.gov/state-agencies/audits/2021/11/19/management-invasive-species-followPurchasing and Procurement Practices
… Section 208 of the Racing, Pari-Mutuel Wagering and Breeding Law requires all contracts entered into by NYRA for …
https://www.osc.ny.gov/state-agencies/audits/2022/03/16/purchasing-and-procurement-practicesOversight of the Farm-to-School Program (Follow-Up)
… relationships between schools. The Program is intended to connect schools with local farms and food producers, …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/oversight-farm-school-program-followCVS Health – Temporary Holding Account Rebate Revenue (Follow-Up)
… included in our initial audit report, Temporary Holding Account Rebate Revenue ( 2019-S-27 ). Background The New York … eligible prescription drug claims in its temporary holding account. We found that CVS Health improperly designated a temporary holding account, used to process certain prescription drug claims, as …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/cvs-health-temporary-holding-account-rebate-revenue-followCompliance With Jonathan’s Law (Follow-Up)
… of the three recommendations included in our initial audit report, Compliance With Jonathan’s Law (Report 2017-S-67 ). About the Program In February 2007, … of the three recommendations included in our initial audit report Compliance With Jonathans Law Report 2017S67 …
https://www.osc.ny.gov/state-agencies/audits/2021/02/25/compliance-jonathans-law-followAccess Controls Over Selected Critical Systems (Follow-Up)
… vulnerable adult protective services; preventive services for children and families; and juvenile justice. OCFS owns … inappropriate access to OCFS systems because OCFS hadn’t performed required annual user reviews. We also found OCFS …
https://www.osc.ny.gov/state-agencies/audits/2020/12/29/access-controls-over-selected-critical-systems-followLong-Term Care Ombudsman Program (Follow-Up)
… made in our initial audit report, Long-Term Care Ombudsman Program (Report 2018-S-48 ). About the Program … to establish an Office of the State Long-Term Care Ombudsman. In New York, this office (hereafter referred to as … housing more than 160,000 residents who have a need for ombudsman services. The Office’s responsibilities include …
https://www.osc.ny.gov/state-agencies/audits/2020/12/31/long-term-care-ombudsman-program-followUse of Vendor-Supported Technology (Follow-Up)
… Technology Security Policy (Policy) established by the New York State Office of Information Technology … levels. However, we identified unsupported systems used by NFTA on 66 devices. We found that NFTA officials did not develop …
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/use-vendor-supported-technology-followAdministration of Mitchell-Lama Waiting Lists (Follow-Up)
… of 269 State-supervised developments, with over 105,000 apartments, were built under the Program. In exchange for … out, they are no longer subject to DHCR supervision, and apartments do not need to be kept affordable for … Program developments with approximately 64,000 apartments. Apartments are rented or sold to applicants on …
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/administration-mitchell-lama-waiting-lists-follow