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UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers (Follow-Up)
… included in our initial audit report, Overpayments for Out-of-Network Anesthesia Services Provided at In-Network … (Report 2017-S-35 ). About the Program The New York State Health Insurance Program (NYSHIP) covers over 1.2 … Surgery Centers (ASCs) are health care facilities focused on providing same-day surgical care. To help control costs, …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryMedicaid Program – Medicaid Claims Processing Activity October 1, 2015 Through March 31, 2016
… were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit … for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for … providers of about $29 billion. The claims are processed and paid in weekly cycles, which averaged over 7.7 million …
https://www.osc.ny.gov/state-agencies/audits/2016/11/30/medicaid-program-medicaid-claims-processing-activity-october-1-2015-through-march-31-2016Medicaid Program – Medicaid Claims Processing Activity October 1, 2014 Through March 31, 2015
… payments to the providers. The audit covered the period October 1, 2014 through March 31, 2015. Background The … that were either billed at a higher level of care than what was actually provided or were billed with incorrect … Department of Health: Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014 (2013-S-50) …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-program-medicaid-claims-processing-activity-october-1-2014-through-march-31-2015Medicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
… of Health’s eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to … Department of Health (Department) administers the State’s Medicaid program. The Department’s eMedNY computer system …
https://www.osc.ny.gov/state-agencies/audits/2015/05/21/medicaid-program-medicaid-claims-processing-activity-october-1-2013-through-march-31-2014Medicaid Program – Medicaid Claims Processing Activity April 1, 2011 Through September 30, 2011
… of Health: Medicaid Claims Processing Activity October 1, 2010 through March 31, 2011 ( 2010-S-65 ) Department of Health: Medicaid Claims Processing Activity April 1, 2010 through September 30, 2010 (2010-S-15 ) Department of …
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 October 1, 2012 Through March 31, 2013
… Purpose To determine whether the Department of Health's eMedNY system … Medicaid requirements, and resulted in correct payments to the providers. The audit covered the period October 1, … claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to …
https://www.osc.ny.gov/state-agencies/audits/2014/05/22/medicaid-program-medicaid-claims-processing-activity-october-1-2012-through-march-31-2013Overpayments for Services Also Covered by Medicare Part B (Follow-Up)
… two recommendations made in our audit report, Overpayments for Services Also Covered by Medicare Part B (Report … Part B, which provides supplementary medical insurance for a broad range of outpatient medical services, physicians’ fees, and medical supplies. For individuals enrolled in both Medicaid and Medicare, …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followMedicaid Program – Medicaid Claims Processing Activity April 1, 2016 Through September 30, 2016
… $1.1 million in improper episodic payments to home health care providers; $845,824 in overpayments for newborn claims … for inpatient, durable medical equipment, clinic, child care, and transportation services; $160,759 in overpayments … claim that was billed at a higher level of care than what was actually provided; and $25,354 in improper payments …
https://www.osc.ny.gov/state-agencies/audits/2017/07/25/medicaid-program-medicaid-claims-processing-activity-april-1-2016-through-september-30-2016Medicaid Program – Medicaid Claims Processing Activity April 1, 2017 Through September 30, 2017
… were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit covered the … 2017, eMedNY processed over 193 million claims, resulting in payments to providers of more than $31 billion. The claims …
https://www.osc.ny.gov/state-agencies/audits/2018/08/03/medicaid-program-medicaid-claims-processing-activity-april-1-2017-through-september-30-2017City of Yonkers – Budget Review (B24-6-7)
… estimates are not realized. The City plans to borrow up to $15 million for tax certiorari settlements in the … reduce its assessment. The City has likely underestimated police overtime costs by as much as $2 million, employee … instead of using debt. Review the estimates for police overtime, employee retirement, health and dental …
https://www.osc.ny.gov/local-government/audits/city/2024/07/12/city-yonkers-budget-review-b24-6-7Extended School Day Program
… Purpose The objective of our examination was to determine if the State Education Department (Department) paid SCO Family of Services (SCO) for expenses that were appropriate and allowable under the terms and conditions of the contracts and all applicable guidelines. We examined …
https://www.osc.ny.gov/state-agencies/audits/2014/02/25/extended-school-day-programCost Saving Opportunities on Payments of Medicare Part C Claims (Follow-Up)
… Objective To assess the extent of implementation of the recommendation … recipients are also enrolled in Medicare and are referred to as “dual-eligibles.” Medicare Part A provides hospital … & Medicaid Services (CMS) allows state Medicaid programs to determine the payment methodology used for Part C …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/cost-saving-opportunities-payments-medicare-part-c-claims-followIV.3.B Miscellaneous Receipts – IV. Accounting Codes - Uses and Descriptions
… OTB Tickets Uncashed winning tickets. 31023 Unclaimed Lottery Tickets Uncashed winning tickets. 31041 Uncashed … corporation to a for-profit corporation status. 32405 Lottery Tickets Lottery games ticket sales. 32406 Video Lottery Receipts …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv3b-miscellaneous-receiptsDiNapoli Announces State Contract & Payment Actions For March 2014
… Administration contract with WDF Inc. to construct the NYC Court Officer Training Academy. Approved a $27.8 million … and Disability Services (OTDA) award to Legal Services NYC for free civil legal services to 1,000 low income … Center ($1.8 million) and other programs. Contract and Payment Rejections The Comptroller’s office rejected 202 …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-announces-state-contract-payment-actions-march-2014State Contract and Payment Actions in October
… with Jersen Construction Group LLC for construction of a records storage addition at Coxsackie Correctional Facility … Inc. to transport patients. $1.7 million with St. Charles Hospital for inpatient medical care. Department of Motor …
https://www.osc.ny.gov/press/releases/2019/12/state-contract-and-payment-actions-octoberNew York State Health Insurance Program – UnitedHealthcare: Improper Payments for Acupuncture and Acupuncture-Related Services (2020-S-7)
To determine whether UnitedHealthcare Insurance Company of New York appropriately reimbursed acupuncture and acupuncture-related services.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-20s7.pdfOverpayments 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). … Many of the State's Medicaid recipients are also eligible for Medicare Part B, which provides supplementary medical … Generally, Medicare is the primary payer of claims for services provided to dual-eligible recipients. After …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followMedicaid Claims Processing Activity April 1, 2012 Through September 30, 2012
… were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit … for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for … providers of about $25 billion. The claims are processed and paid in weekly cycles, which averaged about 6.3 million …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/medicaid-claims-processing-activity-april-1-2012-through-september-30-2012Medicaid Program – Improper Fee-for-Service Payments for Services Covered by Long-Term Care Plans
… payments for certain services covered by managed long-term care (MLTC) plans. The audit covered the period January 1, … are enrolled in MLTC plans. MLTC plans provide long-term care services, such as home health care, nursing home care, and durable medical equipment, to …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/medicaid-program-improper-fee-service-payments-services-covered-long-term-care-plansState Contract and Payment Actions in May
… In May, the Office of the State Comptroller approved 1,326 contracts for … than 2.5 million payments worth nearly $15.6 billion. The office rejected 123 contracts and related transactions valued … Commission $42.8 million with Highbridge Broadway LLC for office space in Schenectady County. Office of General …
https://www.osc.ny.gov/press/releases/2022/06/state-contract-and-payment-actions-may