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DiNapoli: Former School District Treasurer Sentenced for Stealing Funds
… sentenced in federal court for stealing $34,000 from the Morris Central School District in Otsego County. Hand, 47, of Morris, pled guilty last September to two counts of federal … sentenced in federal court for stealing $34000 from the Morris Central School District in Otsego County …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-former-school-district-treasurer-sentenced-stealing-fundsAlternatives For Children – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Alternatives For Children (Alternatives) on its Consolidated … Alternatives provides preschool special education services to children with disabilities who are between three and five … To determine whether the costs reported by Alternatives For …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/alternatives-children-compliance-reimbursable-cost-manualMedicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… covered the period September 1, 2008 through August 31, 2013. Background Many Medicaid recipients are also enrolled …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… Purpose To determine the extent of implementation of the two … and public housing centers, that provide medical services to underserved areas or populations. Our initial audit … $1 million in potential recoveries were likely lost due to the inaction on overpayments for claims that are now more …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followSubway Service Diversions for Maintenance and Capital Projects (Follow-Up)
… was not adequately informed about diversions, shuttle bus service was not planned using current ridership data, and …
https://www.osc.ny.gov/state-agencies/audits/2015/09/16/subway-service-diversions-maintenance-and-capital-projects-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… for Services Also Covered by Medicare Part B (2010-S-50). Background Many of the State's Medicaid recipients are … Our initial audit report, which was issued on June 20, 2012, examined whether the Department of Health … for Services Also Covered by Medicare Part B (2010-S-50) …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations made in our audit report, … on September 19, 2012, examined whether the Department of Health (Department) had adequate policies and procedures … To determine the extent of implementation of the five recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
To determine the extent of implementation of the five recommendations made in our audit report Improper Managed Care Payments for Certain Medicaid Recipients
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followStatus of the Board-Approved Capital Plan for 2005-2011 (Follow-Up)
… of implementation of the five recommendations included in our initial report, Status of the Board-Approved Capital … the actions taken by the Thruway Authority (Authority) in monitoring and reporting on the status of the project items in the Board-Approved Capital Plan for 2005-2011. We also …
https://www.osc.ny.gov/state-agencies/audits/2013/06/27/status-board-approved-capital-plan-2005-2011-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… range of services including, but not limited to, hospital services, office visits, home care, medical … rate schedules for the payment of inpatient and outpatient hospital services. Empire’s hospital contracts also allow certain special items, such as …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsManagement of Indoor Air Quality for Individuals With Asthma
… reducing hospitalizations due to asthma and limiting exposure to indoor air pollutants that are known asthma … The LHDs did not sufficiently perform the required 1-year follow-up visits to households where at least one … going forward. Ensure all LHDs are conducting the 1-year asthma follow-up visits and using the required form. …
https://www.osc.ny.gov/state-agencies/audits/2022/08/02/management-indoor-air-quality-individuals-asthmaImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… extent of implementation of the 11 recommendations made in our initial audit report, Improper Medicaid Payments for Recipients in Hospice Care ( 2017-S-76 ). About the Program Hospice is a … However, if a Medicaid recipient is also enrolled in Medicare, Medicare is the primary payer and Medicaid is …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followMedicaid Program – Improper Medicaid Payments for Misclassified Patient Discharges
… whether the Medicaid program made inappropriate fee-for-service (FFS) payments to hospitals that failed to … system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients and generates payments to reimburse the providers for their claims. The Department uses the All Patient Refined …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… claims is 80 percent of the R&C rate for the service. R&C rates are updated every six months. From January 1, 2017 … million for 255,807 out-of-network claims based on R&C rates. Key Findings United's automated claims processing … the two most recent R&C rate periods (i.e., reimbursement rates from the prior 12 months) to process all R&C claims – …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… extent of implementation of the two recommendations made in our initial audit report, Maximizing Drug Rebates for … Recovery Plans (Report 2017-S-61 ). About the Program In 1990, Congress created the Medicaid Drug Rebate Program, … from drug manufacturers. The Affordable Care Act, enacted in 2010, extended prescription drug rebates to cover …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/maximizing-drug-rebates-health-and-recovery-plans-followEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… of implementation of the two recommendations included in our initial audit report, Controls Over Payments for … Key Findings Empire officials made significant progress in addressing the problems we identified in the initial audit. In particular, Empire recovered $11.5 …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… care organizations inappropriately paid for durable medical equipment beyond allowed rental limits, and whether the … July 2016 to December 2021 for non-oxygen-related durable medical equipment rentals and September 2018 to December 2021 … care organizations inappropriately paid for durable medical equipment beyond allowed rental limits and whether …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsSelected Aspects of Accommodations for Passengers With Disabilities (Follow-Up)
… by July 1994, absent an extension of time. Any new construction or alteration of an existing station after … PANYNJ staff. Four of the PATH stations, in Manhattan (9th Street, 14th Street, 23rd Street, and Christopher Street) were not …
https://www.osc.ny.gov/state-agencies/audits/2023/05/12/selected-aspects-accommodations-passengers-disabilities-followImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
… included in our initial audit report, Improper Managed Care Payments for Misclassified Patient Discharges (Report … recipients receive their medical services through managed care, whereby the Department pays managed care organizations (MCOs) a monthly premium for each enrolled …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followAnnual Assessment of Market Orders for 2015 and 2016
… Purpose To determine whether the Department of Agriculture and Markets (Department) had adequate procedures in place during the audit period to accurately report its assessable expenses related to its … To determine whether the Department of Agriculture and Markets had adequate procedures in place during the audit period to accurately report its …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/annual-assessment-market-orders-2015-and-2016