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Medicaid 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-31-2016Facility Structure, Safety, and Health Code Waivers (Follow-Up)
… audit report, Facility Structure, Safety, and Health Code Waivers (Report 2014-S - 27). Background There are … in place at a given facility, nor could it identify the code violations that had been waived at those facilities. … of Health: Facility Structure, Safety, and Health Code Waivers ( 2014-S-27 ) …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/facility-structure-safety-and-health-code-waivers-followTrash Can Free Stations Pilot Program (Follow-Up)
… recommendations included in our initial report, Trash Can Free Stations Pilot Program (2014-S-29). Background Our … three recommendations included in our initial report Trash Can Free Stations Pilot Program 2014S29 …
https://www.osc.ny.gov/state-agencies/audits/2017/02/14/trash-can-free-stations-pilot-program-followAdministration of the Article 8-A Loan Program (Follow-Up)
… September 18, 2014, examined whether the loans awarded by HPD under the Article 8-A Loan Program (Program) were being … violations and making other needed repairs. We found that HPD does not verify the accuracy of building owner affidavits … of the Article 8-A Loan Program ( 2013-N-4 ) NYC Department of Consumer Affairs: License Fee Revenues ( …
https://www.osc.ny.gov/state-agencies/audits/2017/04/12/administration-article-8-loan-program-followOversight of Homeless Shelters (Follow-Up)
… of the five recommendations included in our initial audit report, Oversight of Homeless Shelters (Report 2015-S-23 ). Background The Office administers many … habitability at shelters have improved. Of the original report’s five recommendations, four have been implemented and …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-homeless-shelters-followImproper Payments to a Physical Therapist (Follow-Up)
… of implementation of the two recommendations included in our initial audit report, Improper Payments to a Physical … Many of the State’s Medicaid recipients are also enrolled in Medicare, the federal health insurance program for the elderly and disabled. Individuals enrolled in both programs are commonly referred to as “dual-eligible.” …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followOverpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Report 2013-S-57). Background The … care. For example, MCOs receive a “Supplemental Low Birth Weight Newborn Capitation Payment” (low birth weight kick payment) for each enrolled newborn weighing …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followExamination of Unemployment Insurance Willful Overpayments
… at the time the State establishes (e.g., makes a final determination) that a claimant has received an overpayment resulting from a willful misrepresentation, a penalty shall be imposed on the claimant. Key Findings We …
https://www.osc.ny.gov/state-agencies/audits/2018/09/25/examination-unemployment-insurance-willful-overpaymentsExamination of Travel Expenses
… continued to improperly designate the employee’s official station in calendar years 2015, 2016 and 2017. Background As … travel between an employee’s residence and official station is considered commuting and is not reimbursable. The official station of every employee is designated by the head of the …
https://www.osc.ny.gov/state-agencies/audits/2018/07/26/examination-travel-expensesMedicaid Claims Processing Activity October 1, 2011 Through March 31, 2012
… 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, … $4.1 million in overpayments resulting from: Incorrect retroactive rate changes that caused overpayments totaling …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-claims-processing-activity-october-1-2011-through-march-31-2012Medicaid Program – Medicaid Claims Processing Activity April 1, 2011 Through September 30, 2011
… live in New York State; and Improper claims for certain clinic services, physician-administered drugs, and vision …
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 April 1, 2013 Through September 30, 2013
… Department of Health’s eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, … including: $1,822,467 in payments for pharmacy claims that posed patient safety concerns or were not in compliance … claims; $1,826,725 in overpayments for inpatient claims that providers billed at higher levels of care than what was …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013MTA-NYC Transit Medical Assessment Centers
… visited. An employee could be paid as much as $360.22 at a depot that paid for a workday at overtime rates or as little as $86.28 at a depot that paid for three hours at regular pay. We determined … period. Key Recommendations Formally review the varying depot policies pertaining to time and attendance related to …
https://www.osc.ny.gov/state-agencies/audits/2014/11/10/mta-nyc-transit-medical-assessment-centersCollection and Use of Oil Spill Funds
… and collecting appropriate fees from petroleum storage facilities. Facilities with a total petroleum storage capacity of less than 400,000 gallons are registered … discrepancies we identified by periodically analyzing the facility data that it already collects. The Department’s …
https://www.osc.ny.gov/state-agencies/audits/2015/08/13/collection-and-use-oil-spill-fundsMedicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
… improper payments for duplicate billings and hospital, clinic, transportation, and eye care services. By the end of …
https://www.osc.ny.gov/state-agencies/audits/2015/05/21/medicaid-program-medicaid-claims-processing-activity-october-1-2013-through-march-31-2014Housing Preferences for Disabled Veterans (Follow-Up)
… to provide disabled veterans with a preference in the admission to Mitchell-Lama housing developments. Our initial …
https://www.osc.ny.gov/state-agencies/audits/2013/02/19/housing-preferences-disabled-veterans-followMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… being diverted for inappropriate or unauthorized use. The supply limits that the Act imposes vary depending on the … that are highly prone to abuse are limited to a five-day supply, and others that carry less risk are limited to a 30-day supply. During the audit period, the Medicaid program paid …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsQuality of Internal Control Certifications (Follow-Up)
… Purpose In 2012, we conducted a series of audits at 12 State agencies … to determine the degree of implementation by each agency in submitting their 2013-14 Internal Control Certifications … of the seven common recommendations included in our series of reports. Background Our initial audit …
https://www.osc.ny.gov/state-agencies/audits/2015/07/07/quality-internal-control-certifications-followWage Theft Investigations (Follow-Up)
… implementation of the seven recommendations made in our initial report, Wage Theft Investigations (2013-S-38). … that the Department has made substantial progress in addressing the issues identified in our initial report. For example: The Department is now … implementation of the seven recommendations made in our initial report Wage Theft Investigati …
https://www.osc.ny.gov/state-agencies/audits/2015/05/22/wage-theft-investigations-followOversight of Procurements and Loan Programs
… provided adequate oversight of its procurements and loan programs in accordance with the Public Authorities Law (Law) … provided adequate oversight of its procurements and loan programs in accordance with …
https://www.osc.ny.gov/state-agencies/audits/2015/08/04/oversight-procurements-and-loan-programs