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Interdisciplinary Center for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the Interdisciplinary Center for Child Development (ICCD) on its Consolidated Fiscal … To determine whether the costs reported by the Interdisciplinary Center for Child Development on its Consolidated Fiscal Reports were …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/interdisciplinary-center-child-development-compliance-reimbursable-cost-manualReducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
… disease (ESRD) who were eligible for, but not enrolled in Medicare. Medicaid recipients with ESRD may be eligible for Medicare coverage if they meet certain conditions. When Medicaid recipients are enrolled in Medicare, Medicare becomes the primary insurer (payer) and …
https://www.osc.ny.gov/state-agencies/audits/2018/09/05/reducing-medicaid-costs-recipients-end-stage-renal-disease-followAdministration of Contract C007373 With the Institute for Community Living
… Purpose To determine whether the Office of Mental Health (OMH) is effectively administering its contract with the Institute for Community Living (ICL) by ensuring that contracted … To determine whether the Office of Mental Health OMH is effectively administering …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-c007373-institute-community-livingAdministration of the Contract With the Postgraduate Center for Mental Health
… Housing Contract C007374 with the Postgraduate Center for Men …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-postgraduate-center-mental-healthWestchester School for Special Children – Compliance With the Reimbursable Cost Manual
… per the State Education Department's (SED's) Reimbursable Cost Manual (Manual). The audit included the four fiscal … dealer; $1,723 for lodging at the Majestic View Lodge near Zion National Park; $1,620 at a cigar store; and $369 at … SEIT & Preschool, Inc.: Compliance With the Reimbursable Cost Manual (2011-S-13) IncludED Educational Services, Inc.: …
https://www.osc.ny.gov/state-agencies/audits/2013/07/02/westchester-school-special-children-compliance-reimbursable-cost-manualChildren’s Center for Early Learning – Compliance With the Reimbursable Cost Manual
… the Consolidated Fiscal Reports (CFRs) of the Children’s Center for Early Learning (Center) were calculated properly, documented adequately, and … on the Consolidated Fiscal Reports CFRs of the Childrens Center for Early Learning Center were calculated proper …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/childrens-center-early-learning-compliance-reimbursable-cost-manualWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… costs reported on the Consolidated Fiscal Reports (CFRs) of the Whitestone School for Child Development (Whitestone) … education program to disabled children between the ages of three and five years. Whitestone, located in Queens, New … Whitestone officials to help ensure their proper reporting of reimbursable costs. To Whitestone: Ensure that costs …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualUnited HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
… To determine whether Long Island Spine Specialists PC waived Empire Plan members outofpocket costs and if so to …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-spine-specialistsMedicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… 1, 2014 through September 30, 2015. Background MCOs are contractually required to submit encounter transactions … enrolled recipients. The Department uses encounter data for numerous purposes, including, but not limited to, quality … Medicaid MCOs that have not completed testing to ensure they become capable of submitting appropriate encounter …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). … Determine extent of implementation of 3 recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit report, Excessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits … Determine the extent of implementation of 3 recommendations incld in …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followUnited HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… Purpose To determine whether Long Island Laparoscopic Surgery, PLLC waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from … on claims submitted to United by Long Island Laparoscopic Surgery, PLLC (Long Island Laparoscopic), a non-participating …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-laparoscopic-surgeryAstor Services for Children & Families – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Astor Services for Children & Families (Astor) on its Consolidated Fiscal … fiscal year ended June 30, 2013. Background Astor, a not-for-profit organization located in Rhinebeck, New York, … the ages of three and five years. Astor is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-compliance-reimbursable-cost-manualImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… dispense when prescriptions are ordered by telephone or fax. Our initial audit report, which was issued on February … We recommended that the Department review the improper pharmacy claims we identified and make recoveries. We also … included implementing controls to prevent the payment of pharmacy claims for quantities of controlled substances that …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followImproper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … To determine the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followStarting Point Services for Children – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Starting Point Services for Children (Starting Point) on its Consolidated Fiscal … documented, program related, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost … Determine whether the costs reported by Starting Point Services for Children on …
https://www.osc.ny.gov/state-agencies/audits/2015/12/11/starting-point-services-children-compliance-reimbursable-cost-manualUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… To determine whether UnitedHealthcare improperly paid for medical services designated with modifier code 59 that were … with UnitedHealthcare (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s payments to medical providers are based, in part, on procedure codes …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59Milestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the Milestone School for Child Development (Milestone) on its Consolidated Fiscal … Determine whether the costs reported by Milestone School for Child Development on its CFRs were properly documented …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualAdministration of the Contract With the Center for Urban Community Services
… CUCS receives additional funding from the New York City HIV and AIDS Services Administration and the Department of Homeless …
https://www.osc.ny.gov/state-agencies/audits/2016/02/16/administration-contract-center-urban-community-servicesMedicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… whether Medicaid overpaid hospitals by reimbursing for higher levels of medical care than those actually provided to patients. The audit … rehabilitative and psychiatric care. When billing Medicaid for inpatient services, hospitals must indicate a patient's …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissions