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Improper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… $15.6 million in improper Medicaid managed care payments and strengthen efforts to oversee and monitor Medicaid managed care enrollments. Key Finding … two were implemented, two were partially implemented, and one was not implemented. Key Recommendation Officials are …
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
… 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 September … The audit found: $31.4 million in potential overpayments for clinic claims that were processed using an incorrect …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014Enhanced 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)
… New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments to John T. Mather Memorial Hospital … New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments Made to Hudson Valley Hospital Center … New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments Made for Special Items to Selected …
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)
… of implementation of the four recommendations included in our initial audit report, Overpayments of Claims for … Department implemented the new automated crossover system in December 2009 to reduce Medicaid overpayments, it was … therapy during the calendar years 2010 and 2011. In each case, both the provider and the provider's affiliated …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followContract with Daytop Village, Inc. (Follow-Up)
… recommendations included in our initial audit report, Contract with Daytop Village, Inc. (Report 2008-R-1). … under contracts administered by OASAS. One such contract is with Daytop Village, Inc. (Daytop), under which … did not fulfill its fiscal responsibilities under the contract and as a result, OASAS paid Daytop $11.5 million …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/contract-daytop-village-inc-followFood Safety Monitoring
… the processing, distribution and sale of food products in New York State. The audit covers the period April 1, 2011 … establishments, obtaining and analyzing food samples in support of its food safety/recall program, and … food sampling program is a nationally recognized leader in the field. However, all programs could benefit from …
https://www.osc.ny.gov/state-agencies/audits/2014/01/30/food-safety-monitoringSelected Aspects of Bus Fleet Maintenance Report (Follow-Up)
… given 30 days after the issuance of the follow-up review to provide information on any actions that are planned to address the unresolved issues discussed in this review. …
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)
… of implementation of the nine recommendations included in our initial audit report, Selected Aspects of Railcar … are occurring and the reasons they are not performed in a timely manner to ensure that, at a minimum, they meet … NYC Transit and Railway officials have made some progress in correcting the problems we identified. However, …
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
… (2012-S-24) Department of Health: Controls Over eMedNY Edit Changes (2007-S-139) …
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-30-2012Purchasing and Procurement Practices
… the New York Racing Association, Inc. (NYRA) procured goods and services competitively and in accordance with its … all contracts entered into by NYRA for the procurement of goods or services to be pursuant to a competitive bidding … that “Company employees who are entrusted to purchase goods and services are expected to spend the Company’s money …
https://www.osc.ny.gov/state-agencies/audits/2022/03/16/purchasing-and-procurement-practicesOversight of the Farm-to-School Program (Follow-Up)
… and recipient responsibilities. Recipients submit reimbursement requests for expenses and narrative reports on …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/oversight-farm-school-program-followCVS Health – Temporary Holding Account Rebate Revenue (Follow-Up)
… Rebate Revenue ( 2019-S-27 ). Background The New York State Health Insurance Program (NYSHIP), administered by the … insurance coverage to over 1.2 million active and retired State, local government, and school district employees and …
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)
… required. In a sample of 63 record requests, 32 percent (20) were either not provided on time or not provided at all. …
https://www.osc.ny.gov/state-agencies/audits/2021/02/25/compliance-jonathans-law-followAccess Controls Over Selected Critical Systems (Follow-Up)
To assess the implementation of the two recommendations included in our original audit report Access Controls Over Selected Critical Systems Report 2017S56
https://www.osc.ny.gov/state-agencies/audits/2020/12/29/access-controls-over-selected-critical-systems-followLong-Term Care Ombudsman Program (Follow-Up)
… extent of implementation of the five recommendations made in our initial audit report, Long-Term Care Ombudsman … establish an Office of the State Long-Term Care Ombudsman. In New York, this office (hereafter referred to as the … both older adults and persons with disabilities who live in Long-Term Care (LTC) facilities, such as nursing homes, …
https://www.osc.ny.gov/state-agencies/audits/2020/12/31/long-term-care-ombudsman-program-followUse of Vendor-Supported Technology (Follow-Up)
… Frontier Transportation Authority (NFTA) is a New York State public benefit corporation responsible for the … benefit corporation, NFTA must adhere to the New York State Information Technology Security Policy (Policy) established by the New York State Office of Information Technology Services. The Policy …
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/use-vendor-supported-technology-followAdministration of Mitchell-Lama Waiting Lists (Follow-Up)
… of 269 State-supervised developments, with over 105,000 apartments, were built under the Program. In exchange for … out, they are no longer subject to DHCR supervision, and apartments do not need to be kept affordable for … Program developments with approximately 64,000 apartments. Apartments are rented or sold to applicants on …
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/administration-mitchell-lama-waiting-lists-followSelected Controls Over the Property Tax Assessment Process (Follow-Up)
… in our initial report, Selected Controls Over the Property Tax Assessment Process ( 2015-N-1 ). About the … of Finance (DOF) is responsible for assessing all real property throughout the City – approximately 1.05 million … every five years. There are four tax classes for property in New York City: Class 1 covers one- to three-unit …
https://www.osc.ny.gov/state-agencies/audits/2020/01/06/selected-controls-over-property-tax-assessment-process-follow