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RFP#0010 – Financial Organization (Trustee) Services for Length of Service Award Programs
… Request for Proposals Issued May 13, 2025 The Office of the State Comptroller (“OSC”) is seeking … Responses to Questions Amendment #1 , Issued May 14, 2025 Amendment #2 , Issued June 30, 2025 Note: the solicitation has been posted in Adobe Acrobat …
https://www.osc.ny.gov/procurement/rfp0010Administration of the CityFHEPS Program for Department of Homeless Services Shelter Residents
… Objective To determine whether the New York City Department of Social Services is administering the City Fighting … to the rules and regulations, thereby assisting Department of Homeless Services shelter residents in securing permanent … Program New York City has long been plagued by a shortage of affordable housing and a homelessness crisis. In October …
https://www.osc.ny.gov/state-agencies/audits/2024/10/30/administration-cityfheps-program-department-homeless-services-shelter-residentsNew York Institute for Special Education – Compliance With the Reimbursable Cost Manual
… whether the costs reported by the New York Institute for Special Education (Institute) on its Consolidated Fiscal … primarily on expenses claimed on the Institute’s CFR for the fiscal year ended June 30, 2020 and certain expenses claimed on its CFRs for the 2 fiscal years ended June 30, 2019. About the Program …
https://www.osc.ny.gov/state-agencies/audits/2024/12/18/new-york-institute-special-education-compliance-reimbursable-cost-manualMedicaid Program – Medicaid Payments for Early Refills of Prescription Drugs and Supplies
… Medicaid made improper payments on pharmacy claims for early refills of prescription drugs and supplies. The audit … drugs and supplies provided to Medicaid members. Early refills are refills on prescriptions before the previous supply has been fully used. States set early refill thresholds to prevent misuse, overuse, and …
https://www.osc.ny.gov/state-agencies/audits/2026/03/20/medicaid-program-medicaid-payments-early-refills-prescription-drugs-and-suppliesUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… Payments for Medical Services Designated By Modifier Code 59 (Report 2013-S-82 ). Background The New York State Health … indicate the medical services performed. Modifier code 59 is used to indicate that a provider performed a procedure … performed on the same day for the same patient. Modifier 59 is used to identify procedures or services that are not …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… The Department administers the State’s Medicaid program. For the State fiscal year ended March 31, 2017, New York’s … their members require. As of August 2017, 4.4 million people were enrolled in mainstream managed care plans – about … additional sources of health care coverage. In accordance with the New York State Social Services Law, the Department’s …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… December 31, 2016. Background The New York State Health Insurance Program (NYSHIP), administered by the State … Civil Service (Civil Service), provides health insurance coverage to active and retired State, participating local … testing, outpatient surgery, physical therapy, and home care services. United processes and pays claims from …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatorySchool for Language and Communication Development – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by the School for Language and Communication Development (SLCD) on its … The audit covered the expenses reported on SLCD’s CFR for the fiscal year ended June 30, 2015, and certain expenses reported on SLCD’s CFRs for the two fiscal years ended June 30, 2014. Background SLCD …
https://www.osc.ny.gov/state-agencies/audits/2018/04/16/school-language-and-communication-development-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… determine whether the costs reported by Brookville Center for Children’s Services, Inc. (Brookville) on its … The audit included expenses claimed on Brookville’s CFR for the fiscal year ended June 30, 2014, and certain expenses claimed on its CFRs for the two fiscal years ended June 30, 2013. Background …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualLifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… fiscal years ended June 30, 2014. Background Lifeline is a Queens, New York-based not-for-profit organization authorized …
https://www.osc.ny.gov/state-agencies/audits/2017/10/12/lifeline-center-child-development-inc-compliance-reimbursable-cost-manualUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… December 31, 2014. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … to process and pay medical claims from health care providers for services provided to Empire Plan members. …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… compliance with the New York State Controlled Substances Act, which limits the quantities of controlled substances … care needs. The New York State Controlled Substances Act (Act), which was enacted to combat illegal use of controlled … compliance with the New York State Controlled Substances Act …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… costs, and if so, to quantify the overpayments made by United HealthCare resulting from this practice. The audit … 2011 through March 31, 2015. Background The New York State Health Insurance Program (NYSHIP) provides health insurance … covering a range of services from inpatient hospital care to outpatient surgical procedures and physician office …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial audit report, … made improper payments totaling $94,460 to Davis Ethical Pharmacy. Based on information obtained from the prescribers … Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11) United HealthCare Insurance Program: …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… 31, 2013. Background Medicaid provides a wide range of medical services to those who are economically disadvantaged … health care needs. In general, the Medicaid program pays medical providers through either the fee-for-service method …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careEducators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)
… included in our initial audit report, Educators for Children, Youth and Families, Inc. - Use of Contract Funds … issued on August 20, 2010, examined whether Educators for Children, Youth and Families, Inc. (Educators) appropriately … the State Education Department (SED) and the Office of Children and Family Services (OCFS) under grant contracts for …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/educators-children-youth-and-families-inc-use-contract-funds-followMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… freestanding sites. They can be classified into three general categories: diagnostic, therapeutic, and custodial. … the costs of most medical care provided during a hospital admission. As such, claims for ancillary services provided during a hospital admission are generally not reimbursable. In 2007, the …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… The Doctor was listed as the prescriber on 31,351 (63 percent) of the 50,060 claims. Key Findings Based on a … wherein the drug and drug strength were different from what the physician prescribed; and Claims for unauthorized … we found: The Doctor was listed as the prescriber on 63 percent of Joia’s claims; among these claims, we found …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/medicaid-program-medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriberOversight of Hotels and Motels Used for Homeless and Mixed-Use Temporary Residency
… outside of NYC, 24 (42 percent) do not have a dedicated shelter facility. OTDA has assigned responsibility for the …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-hotels-and-motels-used-homeless-and-mixed-use-temporary-residencyMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… Purpose To determine whether the Department of Health took sufficient steps to control the Medicaid costs of recipients diagnosed with … To determine whether the Department of Health took sufficient …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-disease