Search
UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… overpaid for out-of-network anesthesia services provided at Ambulatory Surgery Centers that were contractually required to use … health care providers who agree to accept payments, at rates established by United, to furnish medical/surgical … overpaid for outofnetwork anesthesia services provided at Ambulatory Surgery Centers that were contractually …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryThe New Interdisciplinary School – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by The New Interdisciplinary School (NIS) on its Consolidated Fiscal Reports (CFR) were properly … To determine whether the costs reported by The New Interdisciplinary School on its …
https://www.osc.ny.gov/state-agencies/audits/2017/12/08/new-interdisciplinary-school-compliance-reimbursable-cost-manualHawthorne Foundation, Inc. – Compliance With the Reimbursable Cost Manual
… not-for-profit special education provider located in Westchester County, New York. Hawthorne provides preschool … 30, 2015, Hawthorne reported approximately $2.8 million in reimbursable costs on its CFR for one rate-based preschool … the fiscal year ended June 30, 2015, we identified $75,189 in ineligible costs that Hawthorne reported on its CFR for …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/hawthorne-foundation-inc-compliance-reimbursable-cost-manualPrograms for Little Learners – Compliance With the Reimbursable Cost Manual
… whether the costs reported by Programs For Little Learners (PFLL) on its Consolidated Fiscal Reports (CFRs) … whether the costs reported by Programs For Little Learners on its Consolidated Fiscal Reports were properly …
https://www.osc.ny.gov/state-agencies/audits/2018/09/24/programs-little-learners-compliance-reimbursable-cost-manualNew York Therapy Placement Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by New York Therapy Placement Services, … calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the Reimbursable Cost Manual (RCM). The audit covered …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/new-york-therapy-placement-services-inc-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Brookville Center for Children’s Services, Inc. (Brookville) on its … (CFRs) were reasonable, necessary, directly related to the special education program, and sufficiently documented … Determine whether the costs reported by Brookville Center for Childrens …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualUnity House of Troy – Compliance With the Reimbursable Cost Manual
… for the rate-based preschool special education programs it operated. Key Findings For the calendar year ended December … of its classrooms for a full year, although the classroom operated for only part of the year; and $82,694 in other than …
https://www.osc.ny.gov/state-agencies/audits/2015/11/05/unity-house-troy-compliance-reimbursable-cost-manualEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Follow-Up)
… for Special Items for the Period January 1, 2012 Through June 30, 2012 (Report 2012-S-132). Background The New York … for special items. For the period January 1, 2012 through June 30, 2012, Empire paid over $71 million for 38,381 claims … during the six-month period January 1, 2012 through June 30, 2012, Empire made a net overpayment of $391,894 on …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations made in our audit report, New York … To determine the extent of implementation of 3 recommendations made in our audit …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations made in our initial audit report, … To determine the extent of implementation of 3 recommendations made in our intl audit …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followThe Arc of Orange County – Compliance With the Reimbursable Cost Manual
… reported on its CFR for the year ended December 31, 2013. In addition, we expanded our audit work to review certain … not-for-profit special education provider located in Orange County, New York. Arc Orange provides preschool … December 31, 2013, Arc Orange reported over $5.5 million in reimbursable costs on its CFR for four rate-based …
https://www.osc.ny.gov/state-agencies/audits/2016/03/17/arc-orange-county-compliance-reimbursable-cost-manualUnited HealthCare – Empire Plan Drug Rebate Revenue
… remitted all drug rebate revenue to the Department of Civil Service (Department) as required by the contract … discounts, and other considerations and pass 100 percent of the value of the agreements on to the prescription drug program. For … remitted all drug rebate revenue to the Department of Civil Service as required by the contract between United …
https://www.osc.ny.gov/state-agencies/audits/2016/11/01/united-healthcare-empire-plan-drug-rebate-revenueThrough Ages, Inc. – Compliance With the Reimbursable Cost Manual
… the ages of three and five years. During the 2014-15 school year, Through Ages served 198 students. Through Ages …
https://www.osc.ny.gov/state-agencies/audits/2020/06/03/through-ages-inc-compliance-reimbursable-cost-manualNew York Youth Jobs Program (Follow-Up)
… Employers are entitled to claim tax credits equal to $750 per month, for up to six months, for each full-time … (or 10 hours per week for employees enrolled full-time in high school). Retaining employees beyond the initial six months …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/new-york-youth-jobs-program-followAnthem Blue Cross – Coordination of Benefits With Medicare
… Objective To determine whether Anthem Blue Cross coordinated benefits to properly pay claims for NYSHIP Empire Plan members with Medicare … To determine whether Anthem Blue Cross coordinated benefits to properly pay claims for NYSHIP Empire Plan members with Medicare …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
… Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to over … insurance plan for NYSHIP, covering 1.1 million members. Civil Service contracts with Carelon Behavioral Health …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andCity of Yonkers – Budget Review (B6-16-10)
… and expenditure projections in the City’s proposed budget for the 2016-17 fiscal year are reasonable. Background The City of Yonkers is authorized to issue debt totaling $45 million to liquidate …
https://www.osc.ny.gov/local-government/audits/city/2016/05/19/city-yonkers-budget-review-b6-16-10State Comptroller DiNapoli Releases State Audits and Examinations
… operational and technical security controls over the protection of cardholder data at the authority. They … operational and technical security controls over the protection of cardholder data at the authority …
https://www.osc.ny.gov/press/releases/2017/02/state-comptroller-dinapoli-releases-state-audits-and-examinationsImproper Payments Related to the Center of Excellence for Cancer Program
… Program (NYSHIP), administered by the Department of Civil Service (Civil Service), is one of the nation’s largest public sector … to determine which payment (Anthem’s or United’s) should be remitted to Civil Service; and $2.3 million has not been …
https://www.osc.ny.gov/state-agencies/audits/2026/01/27/improper-payments-related-center-excellence-cancer-programAnthem Blue Cross – Effectiveness of the Recovery Process
… Anthem Blue Cross (Anthem) effectively administered the recovery process and remitted all recoveries that the Department of Civil Service (Civil Service) was entitled to. The audit … whether Anthem Blue Cross Anthem effectively administered the recovery process and remitted all recoveries that the …
https://www.osc.ny.gov/state-agencies/audits/2026/01/06/anthem-blue-cross-effectiveness-recovery-process