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New York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… our initial audit report, Payments by Empire BlueCross for Hospital Services for Ineligible Members (Report 2019-S-32 ). … Empire BlueCross (Empire) to administer the Empire Plan’s hospital benefits. Civil Service maintains the New York … August 18, 2020, sought to determine whether Empire paid hospital claims for members who were not eligible for …
https://www.osc.ny.gov/state-agencies/audits/2021/12/27/new-york-state-health-insurance-program-payments-empire-bluecross-hospital-servicesKids First Evaluation & Advocacy Center – Compliance with the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Kids First … Kids First provides preschool special education services to children with disabilities who are between 3 and 4 years … reported by Kids First on the annual CFR that it submits to SED. Costs reported on the CFR must comply fully with the …
https://www.osc.ny.gov/state-agencies/audits/2022/03/02/kids-first-evaluation-advocacy-center-compliance-reimbursable-cost-manualOversight of Construction Management Contracts (Follow-Up)
… initial audit report, Oversight of Construction Management Contracts (Report 2020-S-43 ). About the Program The Office … are executed and constructed properly, Parks occasionally contracts with firms that specialize in providing … addition to the DASNY contract, Parks enters into 3-year contracts with private firms to serve as the construction …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/oversight-construction-management-contracts-followCompliance With Executive Order 95 (Open Data)
To determine whether the Olympic Regional Development Authority is complying with Executive Order 95 including providing in a timely manner publishable State data to the Office of Information Technology Services
https://www.osc.ny.gov/state-agencies/audits/2021/02/08/compliance-executive-order-95-open-dataCompliance With Requirements to Maintain Systems at Vendor-Supported Levels (Follow-Up)
To assess the extent of implementation of the two recommendations included in our initial audit report Compliance With Requirements to Maintain Systems at VendorSupported Levels
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/compliance-requirements-maintain-systems-vendor-supported-levels-followAllocation, Billing, and Collection of Expenses of Administering the Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act (Follow-Up)
… Safety Responsibility Act (collectively, “Acts”) pursuant to Articles VI and VII of the Vehicle and Traffic Law. These … adequate insurance coverage, or are financially secure, to compensate persons they might injure or whose property … as a result of an accident. Department activities relating to the Acts fall into three program areas: the Dedicated …
https://www.osc.ny.gov/state-agencies/audits/2021/05/27/allocation-billing-and-collection-expenses-administering-motor-vehicle-financial-securityUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Follow-Up)
… Objective To assess the extent of implementation of the two … Civil Service contracted with UnitedHealthcare (United) to administer the medical/surgical portion of the Empire … given 30 days after the issuance of the follow-up report to provide information on any actions that are planned to …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesCompliance With Executive Order 88 – Energy Efficiency in State Buildings
… Objectives To determine if the Department of Corrections and Community … Supervision (DOCCS) has developed targets and plans to effectively meet its contributions toward Executive Order … To determine if the Department of Corrections and Community …
https://www.osc.ny.gov/state-agencies/audits/2020/01/30/compliance-executive-order-88-energy-efficiency-state-buildingsBehavior Analysts of New York, LLC – Compliance With the Reimbursable Cost Manual
… Objective To determine whether reported costs submitted by Behavior Analysts of New York, LLC (BANY) on its Consolidated Fiscal Report (CFR) … provider of preschool special education services to children with disabilities who are between three and five … To determine whether reported costs submitted by Behavior …
https://www.osc.ny.gov/state-agencies/audits/2020/01/31/behavior-analysts-new-york-llc-compliance-reimbursable-cost-manualMedicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY (Follow-Up)
… Objective To determine the extent of implementation of the five … Overpayments for Medicare Part B Services Billed Directly to eMedNY (Report 2017-S-36 ). About the Program The … To determine the extent of implementation of the five …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-part-b-services-billed-directly-emedny-followMedicaid Overpayments for Medicare Advantage Plan Services (Follow-Up)
… Objective To determine the extent of implementation of the five … are also enrolled in Medicare Part C, commonly referred to as Medicare Managed Care or Medicare Advantage. Under Part … benefits and offer different health care plans (referred to as Medicare Advantage plans [Plans]) to meet the specific …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followSummit Security Services, Inc. (Summit)
… determine whether individuals who performed security guard and fire safety director services at three New York City … OGS paid Summit nearly $2.8 million for security guard and fire safety director services provided at the Shirley A. … the Adam Clayton Powell, Jr. State Office Building; and the James A. Farley Building in New York City during the …
https://www.osc.ny.gov/state-agencies/audits/2020/08/03/summit-security-services-inc-summitNational Directory of New Hires Data Security
… The Office of Temporary and Disability Assistance (OTDA) is responsible for supervising State programs that provide … Services (Health and Human Services). The Directory data is comprised of information on new hires, quarterly wage, and … for securing Directory data. We found that OTDA is fully compliant with 31 of the 32 requirements; the …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/national-directory-new-hires-data-securityImproper Medicaid Payments for Misclassified Patient Discharges (Follow-Up)
… for inpatient medical care. The DRG methodology classifies patients according to their diagnosis and severity of …
https://www.osc.ny.gov/state-agencies/audits/2023/01/18/improper-medicaid-payments-misclassified-patient-discharges-followNew York State Health Insurance Program – Payments by CVS Health for Pharmacy Services for Ineligible Members (Follow-Up)
… Objective To assess the extent of implementation of the six … dependents. Civil Service contracts with CVS Health (CVS) to administer the Empire Plan’s pharmacy benefits. Civil … a daily update file of NYBEAS changes, and CVS has access to NYBEAS to confirm eligibility information. Timely and …
https://www.osc.ny.gov/state-agencies/audits/2023/01/04/new-york-state-health-insurance-program-payments-cvs-health-pharmacy-services-ineligibleState Education Department Examination of Payments to Tough Man, Inc.
… (SED) made under contracts C813016, C81403A, T815055, and T816040 to Tough Man Inc. (Tough Man). The objectives of our examination were … whether funds were used for the contracts’ purposes, and whether the expenses claimed exceeded program revenues as … SED made under contracts C813016 C81403A T815055 and T816040 to Tough Man Inc Tough Man Th …
https://www.osc.ny.gov/state-agencies/audits/2019/03/01/state-education-department-examination-payments-tough-man-incCompliance With Requirements to Maintain Systems at Vendor-Supported Levels
… Objective To determine whether the Rochester-Genesee Regional Transportation Authority (RGRTA) was complying with … 2019 through April 3, 2019. About the Program RGRTA is a regional transportation authority established by New York … To determine whether the RochesterGenesee Regional Transportation Authority was complying with …
https://www.osc.ny.gov/state-agencies/audits/2019/07/29/compliance-requirements-maintain-systems-vendor-supported-levelsMedicaid Program – Improper Medicaid Payments for Recipients in Hospice Care
… medical social services, drugs for symptom control and pain relief, counseling, and physical and occupational …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-improper-medicaid-payments-recipients-hospice-careFood Metrics Implementation (Follow-Up)
… their New York State food purchases, the State Finance Law (Law) requires the Office of General Services (OGS) and the … regulations, establish guidelines, and provide training on New York State food purchasing to agency personnel …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/food-metrics-implementation-followMedicaid Payments to Medicare Advantage Plan Providers (Follow-Up)
… extent of implementation of the three recommendations made in our initial audit report, Medicaid Payments to Medicare … Many of the State’s Medicaid recipients are also enrolled in Medicare, the federal health insurance program for people … specific needs of beneficiaries. For individuals enrolled in Medicaid and Medicare, providers bill Medicaid for the …
https://www.osc.ny.gov/state-agencies/audits/2019/10/15/medicaid-payments-medicare-advantage-plan-providers-follow