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Improper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… of the five recommendations made in our audit report, Improper Managed Care Payments for Certain Medicaid Recipients (Report 2010-S-66). Background Our initial audit report, which … of the five recommendations made in our audit report Improper Managed Care Payments for Certain Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followMedicaid Program – Medicaid Claims Processing Activity April 1, 2014 Through September 30, 2014
… audit found: $31.4 million in potential overpayments for clinic claims that were processed using an incorrect pricing … improper payments for HIV tests, duplicate billings, and clinic, practitioner, and health home services. By the end of …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014American Academy of Pediatrics, District II
… Purpose In conjunction with our Investigations Unit, we examined … to determine whether the expenses were bona fide and made in accordance with the contracts. Background During the … Assistant, and wages reportedly paid to the AAP webmaster. In six instances, the Executive Director submitted false …
https://www.osc.ny.gov/state-agencies/audits/2014/02/28/american-academy-pediatrics-district-iiEnhanced Medicaid Payments to Selected Home Health Care Service Providers (Follow-Up)
… audit report, Enhanced Medicaid Payments to Selected Home Health Care Service Providers (Report 2009-S-25). … issued on September 24, 2010, examined whether selected home health care providers properly used Medicaid funds for … 2006 through 2011, to organizations that provide certain home health care services to Medicaid recipients. The …
https://www.osc.ny.gov/state-agencies/audits/2013/09/05/enhanced-medicaid-payments-selected-home-health-care-service-providers-followEmpire BlueCross BlueShield – Payments to John T. Mather Memorial Hospital (Follow-Up)
… Network allows the hospitals to be reimbursed for special items (e.g., implants, drugs, and blood) that are not … and procedures to ensure that payments for certain special items claimed by Mather were appropriate. Empire’s agreement … did not define the amount hospitals could bill for special items. As a result, Mather substantially marked-up the …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/empire-bluecross-blueshield-payments-john-t-mather-memorial-hospital-followOverpayments of Claims for Selected Professional Services (Follow-Up)
… implementation of the four recommendations included in our initial audit report, Overpayments of Claims for Selected Professional Services (Report 2010-S-73). … implementation of the four recommendations included in our initial audit report Overpayments of Claims for Selected …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followContract with Daytop Village, Inc. (Follow-Up)
… report, Contract with Daytop Village, Inc. (Report 2008-R-1). Background The Office of Alcoholism and Substance Abuse …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/contract-daytop-village-inc-followFood Safety Monitoring
… monitors the processing, distribution and sale of food products in New York State. The audit covers the period … 18, 2013. Background The Department's Division of Food Safety and Inspection (Division) is responsible for … enforcing State laws and Department regulations related to food safety. The Division's objective is to ensure a safe and …
https://www.osc.ny.gov/state-agencies/audits/2014/01/30/food-safety-monitoringSelected Aspects of Bus Fleet Maintenance Report (Follow-Up)
… in our initial audit report, Selected Aspects of Bus Fleet Maintenance (Report 2009-S-51). Background Our initial audit … whether the MTA (1) has standards and procedures for the maintenance of its bus fleet, (2) performs bus maintenance in compliance with these standards and …
https://www.osc.ny.gov/state-agencies/audits/2013/07/11/selected-aspects-bus-fleet-maintenance-report-followSelected Aspects of Railcar Fleet Maintenance (Follow-Up)
… usually performed on time, there was still an opportunity for improvement because this was not always the case. We … that Transit and Railway re-assess the 80-percent goal for timeliness of inspections to determine whether a higher … the inspection interval for the newest classes of cars. Key Findings MTA – NYC Transit and Railway officials …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/selected-aspects-railcar-fleet-maintenance-followMedicaid Program – Medicaid Claims Processing Activity October 1, 2012 Through March 31, 2013
… pertaining to recipients' other health insurance coverage; $2,689,352 in inappropriate payments for lab … drugs, hospital services, medical equipment, and dental services. By the end of the audit fieldwork, auditors … charged with or found guilty of crimes that violate health care programs' laws or regulations. The Department terminated …
https://www.osc.ny.gov/state-agencies/audits/2014/05/22/medicaid-program-medicaid-claims-processing-activity-october-1-2012-through-march-31-2013Medicaid Claims Processing Activity April 1, 2012 Through September 30, 2012
… Claims with incorrect billings for alternate levels of care, which caused $465,313 in overpayments; Claims for dental services that should have been covered by a managed care plan, which caused $336,780 in overpayments; and Claims …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/medicaid-claims-processing-activity-april-1-2012-through-september-30-2012Management of Invasive Species (Follow-Up)
… of the four recommendations included in our initial audit report, Management of Invasive Species (Report 2019-S-26 ) . About the Program Many species of plants … of the four recommendations included in our initial audit report Management of Invasive Species Report 2019S26 …
https://www.osc.ny.gov/state-agencies/audits/2021/11/19/management-invasive-species-followPurchasing and Procurement Practices
… New York Racing Association, Inc. (NYRA) procured goods and services competitively and in accordance with its policies and procedures. Our audit covered the period from January … the New York Racing Association Inc NYRA procured goods and services competitively and in accordance with its …
https://www.osc.ny.gov/state-agencies/audits/2022/03/16/purchasing-and-procurement-practicesOversight of the Farm-to-School Program (Follow-Up)
… Objective To determine the extent of implementation of the two recommendations included in our initial audit report, Oversight of the Farm-to-School Program (Report 2020-S-9 ). About the … To determine the extent of implementation of the two recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/oversight-farm-school-program-followCVS Health – Temporary Holding Account Rebate Revenue (Follow-Up)
… employees and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 … prescription drug claims, as “non-rebate-eligible.” As a result, CVS Health did not seek rebates from drug … “non-rebate-eligible” designation from the account. As a result, we projected Civil Service would receive additional …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/cvs-health-temporary-holding-account-rebate-revenue-followCompliance With Jonathan’s Law (Follow-Up)
… developmentally disabled boy, died while in the care of a State facility operated by the Office of Mental Retardation … neglect while at a privately run facility and then at a State-run facility. In May 2007, “Jonathan’s Law” was enacted … is later. OPWDD operates 13 Developmental Disabilities State Operations Offices in six regions across the State to …
https://www.osc.ny.gov/state-agencies/audits/2021/02/25/compliance-jonathans-law-followAccess Controls Over Selected Critical Systems (Follow-Up)
… vulnerable adult protective services; preventive services for children and families; and juvenile justice. OCFS owns …
https://www.osc.ny.gov/state-agencies/audits/2020/12/29/access-controls-over-selected-critical-systems-followLong-Term Care Ombudsman Program (Follow-Up)
… who live in Long-Term Care (LTC) facilities, such as nursing homes, assisted living, and board and care homes. … State lack regular access to ombudsman services, due in part to a decline in the number of volunteers combined with a …
https://www.osc.ny.gov/state-agencies/audits/2020/12/31/long-term-care-ombudsman-program-followUse of Vendor-Supported Technology (Follow-Up)
… the NFTA Metro Bus and Rail System, the Buffalo-Niagara International Airport, and Niagara Falls International Airport. NFTA has approximately 1,500 …
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/use-vendor-supported-technology-follow