Search
Improper Medicaid Payments to Eye Care Providers
… Purpose To determine (1) whether certain eye care providers who appeared to be affiliated complied with Medicaid provider enrollment … To determine whether certain eye care providers who appeared to be affiliated complied with Medicaid provider enrollment …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/improper-medicaid-payments-eye-care-providersImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (2018-S-71)
To determine whether Medicaid made improper payments to providers on behalf of dual-eligible individuals receiving hospice care covered by Medicare.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-18s71.pdfState Agencies Bulletin No. 1037
… Purpose To describe the new process for withholding taxes and reporting wages when an … recovery of an overpayment from a prior year. As a result, new procedures for recovering overpayments are required to comply with these regulations. Overview of New Approach Whenever an overpayment is recovered, it is …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1037-taxation-recovered-salary-overpaymentsXI.4.D Indirect Cost Allocations – XI. Procurement and Contract Management
… the method or basis for allocation should be identified. In situations where the contractor provides services funded … allocated to the State.The following criteria must be met in determining when indirect costs are allowable: The … agency policy or contract. The items of expense included in the allocation to the state contract are allowable and not …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi4d-indirect-cost-allocationsReimbursement of Homeless Shelter Providers – Rescue Mission Alliance of Syracuse (Follow-Up)
… 2021-S-34 ). About the Program The Office of Temporary and Disability Assistance (OTDA) administers programs for the State’s low-income residents and provides support, supervision, and guidance to local departments of social services (Local …
https://www.osc.ny.gov/state-agencies/audits/2024/07/26/reimbursement-homeless-shelter-providers-rescue-mission-alliance-syracuse-followMedicaid Program – Oversight of Managed Long-Term Care Member Eligibility
… MLTC plans, which provide long-term care services, such as home health care and nursing home care, for people who are chronically ill or disabled. …
https://www.osc.ny.gov/state-agencies/audits/2022/08/05/medicaid-program-oversight-managed-long-term-care-member-eligibilityState Agencies Bulletin No. 1892
… Purpose The purpose of this bulletin is to inform agencies of the updated IRS (Internal Revenue … and New York tax requirements for 2021. OSC continues to use the Percentage Method on an Annual payroll period for … the criteria outlined in this bulletin. Summary of Changes To date, the IRS has issued guidance on changes to the …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1892-summary-tax-related-changes-2021Medicaid Program – Claims Processing Activity April 1, 2024 Through September 30, 2024
… Objective To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … payments, as follows: $8.3 million was paid for managed care premiums on behalf of Medicaid members who should not … designated as the primary payer instead of another insurer. As a result of the audit, more than $2.6 million of …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/medicaid-program-claims-processing-activity-april-1-2024-through-september-30-2024Medicaid Program – Claims Processing Activity October 1, 2024 Through March 31, 2025
… to providers. However, we also identified the need for improvement in the processing of certain types of claims. The … payments, as follows: $6.4 million was paid for managed care premiums on behalf of Medicaid members who should not … they had other concurrent comprehensive third-party health insurance. $4.1 million was paid for claims that were billed …
https://www.osc.ny.gov/state-agencies/audits/2026/03/19/medicaid-program-claims-processing-activity-october-1-2024-through-march-31-2025Medicaid Program – Claims Processing Activity April 1, 2022 Through September 30, 2022
… Objective To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … back to January 2022. About the Program The Department of Health (Department) administers the State’s Medicaid … 224 million claims, resulting in payments to providers of nearly $38 billion. The claims are processed and paid in …
https://www.osc.ny.gov/state-agencies/audits/2023/05/11/medicaid-program-claims-processing-activity-april-1-2022-through-september-30-2022United Cerebral Palsy Association of the Rochester Area, Inc. – Compliance With the Reimbursable Cost Manual
… ended December 31, 2013. Background UCP Rochester, a not-for-profit organization located in Rochester, New York, is an … preschool special education services to about 90 children from 16 school districts located in Monroe and Ontario … counties in western New York. UCP Rochester is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-cerebral-palsy-association-rochester-area-inc-compliance-reimbursable-cost-manualNewmeadow, Inc. – Compliance With the Reimbursable Cost Manual
… between the ages of three and five years. Newmeadow is reimbursed for preschool special education services …
https://www.osc.ny.gov/state-agencies/audits/2015/12/29/newmeadow-inc-compliance-reimbursable-cost-manualXIII.2.C Expense Report Certification – XIII. Employee Expense Reimbursement
… SECTION OVERVIEW AND POLICIES Expense reports must be certified by the employee requesting reimbursement, the … claimed. This section describes the process that must be followed for expense reports that are direct-entered into … Claim for Payment ( AC 132-S* ). (This document can either be submitted to a proxy for processing, or submitted through …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xiii/xiii2c-expense-report-certificationJohn A. Coleman School – Compliance With the Reimbursable Cost Manual
To determine whether the costs reported by the John A Coleman School Coleman on its Consolidated Fiscal Reports CFRs were properly calculated
https://www.osc.ny.gov/state-agencies/audits/2013/08/05/john-coleman-school-compliance-reimbursable-cost-manualGanrormic, Inc. – Compliance With the Reimbursable Cost Manual
… and allowable under the State Education Department’s (SED) guidelines, including the Reimbursable Cost Manual (RCM). The … for reimbursement, reported costs must comply with the guidelines in the RCM. For the fiscal year ended June 30, … rates. Remind Ganrormic officials of the pertinent SED guidelines that relate to the deficiencies we identified. To …
https://www.osc.ny.gov/state-agencies/audits/2017/03/21/ganrormic-inc-compliance-reimbursable-cost-manualSpotted Zebra Learning Center, Inc. – Compliance With the Reimbursable Cost Manual
… audit covered the costs reported on Spotted Zebra’s CFR for the fiscal year ended June 30, 2014 and certain costs … pay tuition to Spotted Zebra for these services using reimbursement rates set by SED; the State, in turn, … Zebra reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the guidelines …
https://www.osc.ny.gov/state-agencies/audits/2017/04/12/spotted-zebra-learning-center-inc-compliance-reimbursable-cost-manualVariety Child Learning Center – Compliance With the Reimbursable Cost Manual
… services and programs to children with disabilities from birth to eight years of age. During the period July 1, 2013 … for preschool special education services through rates set by SED. These reimbursement rates are based on financial information, including costs, …
https://www.osc.ny.gov/state-agencies/audits/2017/05/31/variety-child-learning-center-compliance-reimbursable-cost-manualEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012
… Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … above the amount Empire should have paid for the items in question. For one hospital, Empire paid $68,382 for three …
https://www.osc.ny.gov/state-agencies/audits/2013/12/13/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughFinger Lakes United Cerebral Palsy – Compliance With the Reimbursable Cost Manual
… organization located in the Finger Lakes region of central New York, is authorized by SED to provide … to children with disabilities from three to five years of age. During the 2012-13 school year, Happiness House … reimbursement rates. Remind Happiness House officials of the pertinent SED guidelines that relate to the …
https://www.osc.ny.gov/state-agencies/audits/2015/11/05/finger-lakes-united-cerebral-palsy-compliance-reimbursable-cost-manualCost-Saving Ideas: Managing Workers' Compensation Costs
… coverage as a mandatory benefit. Local governments can get insurance for workers’ compensation in one of four … Claims Keep track of where your claims come from so you can actively manage your risk areas and ensure that your … money. Your insurance carrier or a private consulting firm can help you develop policies and procedures to make safety …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-managing-workers-compensation-costs