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Medicaid Program – Improper Payments for Recipients No Longer Enrolled in Managed Long Term Care Partial Capitation Plans
… care for more than 120 days; have both Medicaid and Medicare; and are age 21 or older. Medicaid pays Plans a …
https://www.osc.ny.gov/state-agencies/audits/2016/03/30/medicaid-program-improper-payments-recipients-no-longer-enrolled-managed-long-term-careSelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… Purpose To determine if BlueCross BlueShield’s (Empire’s) payments to Arden Hill … Insurance Program/Department of Civil Service: Empire BlueCross BlueShield - Payments for Selected Items to … To determine if BlueCross BlueShields Empires payments to Arden Hill Hospital …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-arden-hill-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to St. Mary's Hospital from January 1, 2011 through March 31, 2011
… special items were made according to the provisions of the ag …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011Selected Payments for Special Items Made to Albany Medical Center from January 1, 2011 through March 31, 2011
… (Empire’s) payments to Albany Medical Center (AMC) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-albany-medical-center-january-1-2011-through-march-31Selected Payments for Special Items Made to Mount Sinai Hospital from January 1, 2011 through March 31, 2011
… Plan. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … $6,231 from Mount Sinai for the overpayments we identified in this audit. Develop and implement the controls necessary …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-mount-sinai-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to St. Peter's Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield's (Empire's) payments to St. Peter's Hospital (St. Peter's) for special items were made according to the provisions of the agreement between Empire and St. Peter's. Background The New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Assessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… Purpose The purpose of this performance audit is to determine whether the … its assessable expenses related to the administration of Sections 50(5) and 151 of the Workers’ Compensation Law. We performed our audit … The purpose of this performance audit is to determine whether the Workers …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Identifying, Reporting, and Providing Services for Youth at Risk of Sexual Human Trafficking in New York City
… the period from January 2017 through January 2022 for ACS and from January 2017 through September 2021 for DYCD. … including the NYC Administration for Children Services (ACS) – which is overseen by OCFS – and voluntary agencies, on … The annual funding was reduced to $2 million in 2021. ACS was selected to plan and distribute these funds in NYC, …
https://www.osc.ny.gov/state-agencies/audits/2022/06/06/identifying-reporting-and-providing-services-youth-risk-sexual-human-trafficking-new-yorkMedicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… Objective To determine whether Medicaid overpayments for pharmacy services on behalf of managed care recipients who … Medicaid services their recipients require, which includes pharmacy services. Many recipients have other third-party … audit period, HMS’ third-party liability recoveries on MCO pharmacy payments totaled about $118 million. Key Findings We …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsNew York City Department of Homeless Services – Oversight of Contract Expenditures of Institute for Community Living, Inc.
… must comply with DHS’ Human Service Providers Fiscal Manual (Fiscal Manual), the New York City Health and Human Services Cost … sufficient documentation to support proper procurement and maintenance of required inventories. Review ICL’s food …
https://www.osc.ny.gov/state-agencies/audits/2022/09/16/new-york-city-department-homeless-services-oversight-contract-expenditures-instituteSelected Aspects of Leasing Practices for Real Estate Department, Aviation, World Trade Center, and Leasing of Properties
… Objectives To determine whether the Port Authority of New York and New Jersey (PANYNJ) collected … was created to promote and protect the commerce of the Port District – a region within approximately a 25-mile radius of the Statue of Liberty – and to undertake port and regional improvements not likely to be financed by …
https://www.osc.ny.gov/state-agencies/audits/2021/05/04/selected-aspects-leasing-practices-real-estate-department-aviation-world-trade-center-andMedicaid Program – Improper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements
… that require an appropriate National Provider Identifier (NPI) for ordering, prescribing, referring, and attending … for Medicaid claims that did not contain an appropriate NPI in the OPRA fields and resulted in: $1.5 billion in … that did not contain an appropriate referring or attending NPI (for example, some claims contained NPIs of providers who …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-claims-not-compliance-ordering-prescribingInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… made in our initial audit report, Inappropriate Premium Payments for Recipients No Longer Enrolled in … program. Managed care plans (Plans) receive monthly premium payments for individuals enrolled in their plans. The … Department of Health (Department) has the right to recover premium payments from Plans for inappropriately enrolled …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… and/or substance use disorders. Within MMC and HARP is the Integrated Benefits for Dually Eligible Enrollees …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… in addition to Medicaid (e.g., employer-based coverage or Medicare Part A). Medicaid is considered the payer of last …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsIFB #0001 – Disaster Recovery Services for the Printing, Sorting and Mailing of Payroll Checks and Tax Forms
… information as it becomes available, is available for download through the following links: Invitation for Bids , in PDF Forms Only , in MS Word format Cost Proposa l, in MS … in Adobe Acrobat PDF format and may be opened with the free Acrobat reader, available through this link: …
https://www.osc.ny.gov/procurement/ifb0001NYS Comptroller DiNapoli and Church of England Call on ExxonMobil to Set Targets for Lowering GHG Emissions
… along with investors' confidence." Edward Mason, Head of Responsible Investment for the Church Commissioners, said: … with the overarching expectations of the Climate Action 100+ initiative, of ensuring companies develop business … about the importance of releasing a more comprehensive disclosure report. A number of investors have joined the Fund …
https://www.osc.ny.gov/press/releases/2018/12/nys-comptroller-dinapoli-and-church-england-call-exxonmobil-set-targets-lowering-ghg-emissionsDiNapoli: 33.55 Percent Annual Investment Return for New York State Pension Fund Is Largest in Its History
… New York State Comptroller Thomas P. DiNapoli today announced that the New York State Common Retirement Fund’s (Fund) estimated overall … State Comptroller DiNapoli announced that the New York State Common Retirement Funds estimated overall investment …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-33-point-55-percent-annual-investment-return-new-york-state-pension-fund-largest-its-historyOpinion 89-28
… TOWN LAW, §§192-a, 194-a, 202, 202-b: The cost of a water storage tank may be allocated between proposed and existing … water study and the allocation of the cost of a new water storage tank. You indicate that a number of water districts … in the town are supplied by a neighboring city. A storage tank within the city which supplies certain of these …
https://www.osc.ny.gov/legal-opinions/opinion-89-28Schuyler County – Court and Trust Funds (2021-C&T-1)
Determine whether County officials have established appropriate controls to safeguard and account for court and trust funds for the period January 1, 2018 through September 30, 2021.
https://www.osc.ny.gov/files/local-government/audits/2021/pdf/schuyler-county-2021-ct-1.pdf