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Improper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… extent of implementation of the five recommendations made in our audit report, Improper Managed Care Payments for Certain Medicaid Recipients (Report 2010-S-66). … years ended June 30, 2010, Medicaid made $15.6 million in improper managed care payments on behalf of 14,899 …
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)
… the five recommendations included in our initial report, Status of the Board-Approved Capital Plan for 2005-2011 … Authority (Authority) in monitoring and reporting on the status of the project items in the Board-Approved Capital … of Interest New York State Thruway Authority: Status of the Board-Approved Capital Plan for 2005-2011 …
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
… implemented sufficient controls over the identification and recovery of overpayments made to hospitals for special medical items; and took sufficient steps to minimize the State’s risk of … health insurance coverage to about 1.2 million active and retired State, participating local government, and school …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… in our initial audit report, Improper Medicaid Payments for Recipients in Hospice Care ( 2017-S-76 ). About the … elect hospice care, they waive their right to use Medicaid for curative services and a hospice organization assumes responsibility for all medical care related to the terminal illness. …
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
… The State’s Medicaid program is administered by the Department of Health (Department). The Department’s eMedNY … of the discharge (which often meets the definition of a transfer). These claims are at a high risk of overpayment if the first hospital inappropriately reports an actual transfer as a discharge. We selected a judgmental sample of …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesBenefits Advisement Services for Individuals With Disabilities Seeking Employment
… First Commission report. The audit covers the period March 1, 2015 through January 13, 2021. About the Program … Community Survey (ACS). In 2018, there were approximately 1 million working-age adults (ages 21-64) with disabilities …
https://www.osc.ny.gov/state-agencies/audits/2021/07/20/benefits-advisement-services-individuals-disabilities-seeking-employmentUse of Federal Funding for Election Technology and Security
… Security Grant to enhance the security of the State’s election technology and infrastructure. The audit covered … Boards). Congress passed the Help America Vote Act of 2002 (HAVA) to help reform the nation’s voting process. HAVA established minimum election …
https://www.osc.ny.gov/state-agencies/audits/2021/09/17/use-federal-funding-election-technology-and-securityUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million … contracts with United to administer the medical/surgical benefits portion of the Empire Plan. United contracts with in-network providers to deliver services to Empire Plan members. Members may also choose to …
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)
… of Medicaid managed care organizations. In October 2015, adult Medicaid recipients with significant behavioral health …
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)
… Objective To assess the extent of implementation of the two recommendations included in our initial audit report, … To assess the extent of implementation of the two recommendations included in our initial audit report …
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
… under Medicare, oxygen equipment rentals are subject to a 36-month limit. Key Findings We identified overpayments … the Department had adopted a similar policy to Medicare’s 36-month cap on oxygen equipment rental payments. Key …
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)
… public entity created to control the port district of New York and New Jersey, maintaining the trade and travel … were in poor condition at three PATH stations: Newark, Newport, and Grove Street. In the Aviation sector, PANYNJ did …
https://www.osc.ny.gov/state-agencies/audits/2023/05/12/selected-aspects-accommodations-passengers-disabilities-followAnnual Assessment of Market Orders for 2015 and 2016
… To determine whether the Department of Agriculture and Markets (Department) had adequate procedures in place during … to its administration of Article 25 of the Agriculture and Markets Law. Our audit covered the period July 1, 2014 … Program. In addition, Article 25 of the Agriculture and Markets Law authorized market orders and allowed for the …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/annual-assessment-market-orders-2015-and-2016Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services
… whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on APR-DRG (All … may cause Medicaid’s payment to the hospital to increase. For the period of January 1, 2014 through December 31, 2018, Medicaid paid over $522 million to hospitals for 4,874 inpatient APR-DRG claims that included an ICD …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-servicesMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… claims for services also covered by Medicare Advantage plans. The audit covered the period from January 1, 2013 to … Medicare benefits and offer different health care plans (referred to as Medicare Advantage plans) tailored to the specific needs of Medicare … claims for services also covered by Medicare Advantage plans …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… Labor Standards (Division), which, in turn, will conduct investigations to determine compliance. The Law does not … lacked policies and procedures to guide its complaint investigations, resulting in missing documentation, … inconsistent application of the Law, delayed investigations of State-operated facilities, and poor …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-followMedicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… Group codes include PR (patient responsibility) and CO (contractual obligation). CARC 45 occurs when the charge … configured to pay in eMedNY, while claims with a CARC CO 45 are not. All claims submitted for Medicaid members with …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsTown of Somerset – Budgeting for Sales Tax (2016M-419)
… Purpose of Audit The purpose of our audit was to review the Town's allocation of sales tax for the period …
https://www.osc.ny.gov/local-government/audits/town/2017/11/22/town-somerset-budgeting-sales-tax-2016m-419Brighter Choice Charter School for Boys - Payroll (2018M-139)
… paid 15 employees who were paid $123,754 over four payroll periods during the audit period. 1 We reviewed the … Brighter Choice Charter School for Boys Payroll 2018M139 …
https://www.osc.ny.gov/local-government/audits/charter-school/2018/10/12/brighter-choice-charter-school-boys-payroll-2018m-139DiNapoli Calls for Transparency From Companies Regarding Affordability Concerns
… transparency report with credit card companies American Express Co. and Mastercard Inc. Both proposals were withdrawn … study found that nearly 40% of insured adults received a bill for a service they thought was covered but fewer than half had challenged an unexpected bill. At a time when AI is increasingly used by insurance …
https://www.osc.ny.gov/press/releases/2026/03/dinapoli-calls-transparency-companies-regarding-affordability-concerns