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Overpayments of Certain Medicare Crossover Claims (Follow-Up)
… Purpose To determine the extent of implementation of the five … Individuals enrolled in both programs are referred to as “dual-eligibles.” Generally, Medicare is the primary payer for medical services provided to dual-eligibles. Medicaid then typically pays for any …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followMedicaid Payments for Excessive Dental Services (Follow-Up)
… our initial audit report, Medicaid Payments for Excessive Dental Services (Report 2009-S-46). Background Our initial … on August 16, 2010, examined Medicaid payments for routine dental services, such as cleanings and oral evaluations, … 31, 2009. Our audit identified $40 million of excessive dental services that exceeded certain frequency limits (i.e., …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/medicaid-payments-excessive-dental-services-followContract with EBSCO Subscription Services, Inc. (Follow-Up)
… examined billings to one agency, the State University of New York, and found EBSCO was billing in excess of the $35 … None Other Related Audit/Report of Interest New York State Office of General Services: Contract with …
https://www.osc.ny.gov/state-agencies/audits/2013/05/13/contract-ebsco-subscription-services-inc-followUnnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)
… Managed Care Payments for Medicaid Recipients With Medicare (Report 2010-S-75). Background Our initial audit … whether the Department of Health (Department) made premium payments to Medicaid managed care plans for Medicaid recipients who also had Medicare health insurance coverage, known as "dual …
https://www.osc.ny.gov/state-agencies/audits/2013/11/01/unnecessary-managed-care-payments-medicaid-recipients-medicare-followMedicaid Payments for Medicare Part A Beneficiaries (Follow-Up)
… Part A. Medicare Part A provides supplementary medical insurance for inpatient care in hospitals, post-hospital nursing home care, hospice, and home health services. If an … of Health improve its detection of Medicare Part A coverage for Medicaid recipients and prevent improper …
https://www.osc.ny.gov/state-agencies/audits/2014/04/04/medicaid-payments-medicare-part-beneficiaries-followOverpayments to Cabrini Medical Center (Follow-Up)
… overpayments to the Department of Health (Department) for further review. Auditors determined the eMedNY system did …
https://www.osc.ny.gov/state-agencies/audits/2013/11/07/overpayments-cabrini-medical-center-followNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… three recommendations included in our initial report Group Health Incorporated: New York State Dental Program - Payments for Scaling and Root Planing … which was issued on July 28, 2010, examined whether Group Health Incorporated (GHI) established adequate controls over …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of the State's Medicaid recipients are also eligible for Medicare Part B, which provides supplementary medical insurance … health care providers' Medicaid claims for Medicare Part B deductibles and coinsurance. The audit covered the …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followManagement of General School Funds (Follow-Up)
… School Fund (GSF) accounts. We could not fully account for GSF funds, as none of the schools maintained required … The GSF account is used to deposit monies collected for extracurricular and co-curricular activities, such as the …
https://www.osc.ny.gov/state-agencies/audits/2014/09/30/management-general-school-funds-followVehicle and Heavy Equipment Purchase Program (Follow-Up)
… initial report, issued on December 23, 2010 found that the Port Authority generally did not follow required procedures … of 75 items that were purchased for $8.2 million, the Port Authority provided documentation for only two items for $192,279. In addition, the Port Authority included funds for vehicle and equipment …
https://www.osc.ny.gov/state-agencies/audits/2014/11/03/vehicle-and-heavy-equipment-purchase-program-followManagement and Control of Employee Overtime Costs (Follow-Up)
… report, issued on August 17, 2011, determined that the Port Authority of New York and New Jersey (Port Authority) generally did not effectively manage and … proper prior approvals and justification. In addition, the Port Authority did not meet the 20 percent overtime reduction …
https://www.osc.ny.gov/state-agencies/audits/2014/12/19/management-and-control-employee-overtime-costs-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… made in our audit report, Unnecessary Medicaid Payments for Children at Voluntary Agencies (2010-S-47). Background … Department of Health: Unnecessary Medicaid Payments for Children at Voluntary Agencies (2010-S-47) … made in our audit report Unnecessary Medicaid Payments for Children at Voluntary Agencies …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… recommendations made in our audit report, Improper Managed Care Payments for Certain Medicaid Recipients (Report … 30, 2010, Medicaid made $15.6 million in improper managed care payments on behalf of 14,899 recipients who, by State law, were precluded from enrollment in managed care programs. We recommended that the Department investigate …
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
… of about $2.4 million; $555,103 in improper payments for pharmacy claims that were not in compliance with State …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014American Academy of Pediatrics, District II
… Medical Education (CME) credits, program materials, hotel expenses, fringe benefits allegedly paid to the …
https://www.osc.ny.gov/state-agencies/audits/2014/02/28/american-academy-pediatrics-district-iiEnhanced Medicaid Payments to Selected Home Health Care Service Providers (Follow-Up)
… Purpose To determine the extent of implementation of the four … in our initial audit report, Enhanced Medicaid Payments to Selected Home Health Care Service Providers (Report … To determine the extent of implementation of the four …
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)
… Empire BlueCross BlueShield: Payments to John T. Mather Memorial Hospital (Report 2010-S-51), issued on April 23, … is comprised of ten hospitals, including John T. Mather Memorial Hospital (Mather). Empire’s agreement with the … Empire BlueCross Blue Shield - Payments to John T. Mather Memorial Hospital (2010-S-51) New York State Health Insurance …
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)
… in our initial audit report, Overpayments of Claims for Selected Professional Services (Report 2010-S-73). … examined whether inappropriate Medicaid payments were made for selected providers who also received payments from Medicare. For the two year audit period ended December 31, 2011, we …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followContract with Daytop Village, Inc. (Follow-Up)
… Purpose To determine the extent of implementation of the three … OASAS paid Daytop $11.5 million more than it was entitled to. The objective of our follow-up was to assess the extent of implementation, as of October 2012, … To determine the extent of implementation of the three …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/contract-daytop-village-inc-followFood Safety Monitoring
… monitors the processing, distribution and sale of food products in New York State. The audit covers the period … 18, 2013. Background The Department's Division of Food Safety and Inspection (Division) is responsible for … enforcing State laws and Department regulations related to food safety. The Division's objective is to ensure a safe and …
https://www.osc.ny.gov/state-agencies/audits/2014/01/30/food-safety-monitoring