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Maximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… made in our initial audit report, Maximizing Drug Rebates for Health and Recovery Plans (Report 2017-S-61 ). About the Program In 1990, Congress created the Medicaid Drug Rebate Program, which allows states to recover a portion … made in our initial audit report Maximizing Drug Rebates for Health and Recovery Plans Report 2017S61 …
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)
… plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with … rate schedules for the payment of inpatient and outpatient hospital services. Hospitals may be entitled to additional …
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
… care organizations inappropriately paid for durable medical equipment beyond allowed rental limits, and whether … July 2016 to December 2021 for non-oxygen-related durable medical equipment rentals and September 2018 to December 2021 for oxygen-related durable medical equipment rentals. About the Program The Department …
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)
… Objective To determine the extent of implementation of the seven recommendations included in our initial audit report, Selected Aspects of Accommodations for Passengers With Disabilities ( … To determine the extent of implementation of the seven recommendations included in …
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
… Purpose To determine whether the Department of Agriculture and Markets (Department) had adequate … its assessable expenses related to its administration of Article 25 of the Agriculture and Markets Law. Our audit covered the … To determine whether the Department of Agriculture and Markets had adequate procedures in place …
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
… Purpose To determine whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on … To determine whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on …
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
… Purpose To determine if the Department of Health overpaid health care providers’ Medicaid claims for services also covered by Medicare Advantage plans. The audit covered the … To determine if the Department of Health overpaid health care providers Medicaid claims for …
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)
… Objective To determine the extent of implementation of the five recommendations included in our initial audit report Restrictions on Consecutive Hours of Work for Nurses (Report 2017-S-14 ). About the Program The … To determine the extent of implementation of the five recommendations included in our …
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 Medicare and/or other third-party insurance must accurately reflect payments, adjustments …
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)
… of our audit was to review the Town's allocation of sales tax for the period January 1, 2015 through November 18, … million. Key Findings Town officials improperly budgeted sales tax revenue in the refuse district. Key Recommendations Allocate sales tax as allowed by statute. …
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)
… 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
… shareholder proposals with portfolio companies from credit card issuers to health care providers, to challenge business practices that … ranging from predatory pricing to the improper denial of health care coverage. As an investor, we need to know how …
https://www.osc.ny.gov/press/releases/2026/03/dinapoli-calls-transparency-companies-regarding-affordability-concernsDiNapoli: State Needs to Improve Services for Vulnerable Adults
… Services (APS) for vulnerable adults, many of them senior citizens, who need help with food, shelter or medical … each case to determine what help is needed, such as a new living arrangement, money management advice, meal deliveries …
https://www.osc.ny.gov/press/releases/2021/11/dinapoli-state-needs-improve-services-vulnerable-adultsDiNapoli: Help for Vulnerable Adults in NYC Falls Short
… fell short for vulnerable adults in New York City because Adult Protective Services (APS) experienced staff shortages … shortages and high caseloads strained New York City’s Adult Protective Services,” DiNapoli said. “Case files showed … response is available in the audit. Audit Oversight of Adult Protective Services Staffing and Case Management (New …
https://www.osc.ny.gov/press/releases/2025/10/dinapoli-help-vulnerable-adults-nyc-falls-shortNew York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Follow-Up) (2022-F-30)
To assess the extent of implementation of the three recommendations included in our initial audit report, Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Report 2020-S-34).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22f30.pdfNew York State Health Insurance Program – Payments by CVS Health for Pharmacy Services for Ineligible Members (2020-S-17)
To determine whether CVS Health paid pharmacy claims for Empire Plan members who were not eligible.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-20s17.pdfEmpire BlueCross BlueShield Selected Payments for Special Items for the Period July 1, 2011 Through December 31, 2011 (2012-S-3)
To determine whether Empire BlueCross BlueShield (Empire) paid claims for special items according to the provisions of the agreements between Empire and its mem
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2012-12s3.pdfOpinion 92-43
… -- Policies and Procedures (inclusion of purchases by town highway superintendent); (supersession of State statutes … governing contracting process) STREETS AND HIGHWAYS -- Highway Supplies and Equipment (necessity to obtain prior … board approval in procurement policies and procedures) HIGHWAY LAW, §§140, 142, 284; GENERAL MUNICIPAL LAW, §104-b: …
https://www.osc.ny.gov/legal-opinions/opinion-92-43Cybersecurity Governance for Local Governments and Schools – Part 2
This webinar will focus on establishing cybersecurity governance through policies and procedures, training, IT contingency planning and other efforts key to cybersecurity risk decision-making.
https://www.osc.ny.gov/files/local-government/academy/pdf/cybersecurity-governance-part2-102423.pdfEmpire BlueCross – Overpayments for Physician-Administered Drugs (2021-S-33)
To determine whether Empire BlueCross appropriately reimbursed physician-administered drugs.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-21s33.pdf