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Empire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network
… To determine whether Empire BlueCross paid claims for special items according to the terms of its contract with … The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Civil … the hospital portion of this plan. Empire processes claims for hospital services according to contracts it negotiates …
https://www.osc.ny.gov/state-agencies/audits/2019/11/29/empire-bluecross-improper-payments-special-items-billed-hospitals-within-long-island-healthMilestone School for Child Development – Compliance With the Reimbursable Cost Manual
… 30, 2013, Milestone reported approximately $3.8 million in reimbursable costs for its SED Programs. Our audit scope … fiscal years ended June 30, 2013, we identified $801,859 in reported costs that did not comply with Manual … be disallowed. These ineligible costs included $285,455 in personal services costs and $516,404 in other than …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualMedicaid Program – Oversight of Managed Long-Term Care Member Eligibility
… services, such as home health care and nursing home care, for people who are chronically ill or disabled. For the year ended December 31, 2020, Medicaid paid MLTC plans $15.5 billion in premiums for 329,618 recipients enrolled in MLTC. The Department …
https://www.osc.ny.gov/state-agencies/audits/2022/08/05/medicaid-program-oversight-managed-long-term-care-member-eligibilityMedicaid Program – Claims Processing Activity April 1, 2022 Through September 30, 2022
… computer system processes claims submitted by providers for services rendered to Medicaid-eligible recipients and generates payments to reimburse the providers for their claims. During the 6-month period ended September … Medicaid payments, as follows: $10.2 million was paid for managed care premiums on behalf of Medicaid recipients …
https://www.osc.ny.gov/state-agencies/audits/2023/05/11/medicaid-program-claims-processing-activity-april-1-2022-through-september-30-2022Medicaid 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 … back to January 2022. About the Program The Department of Health (DOH) administers the State’s Medicaid program. … 249 million claims, resulting in payments to providers of nearly $50.6 billion. The claims are processed and paid in …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/medicaid-program-claims-processing-activity-april-1-2024-through-september-30-2024Churchill School and Center – Compliance With the Reimbursable Cost Manual
… documented adequately, and reimbursable pursuant to the State Education Department's (SED) Reimbursable Cost Manual … services (Program), pursuant to Section 853 of the State Education Law (Law), to children in kindergarten … Churchill's CFRs. Other Related Audits/Reports of Interest State Education Department: Bilingual SEIT & Preschool, Inc. …
https://www.osc.ny.gov/state-agencies/audits/2014/05/27/churchill-school-and-center-compliance-reimbursable-cost-manualCost-Saving Ideas: Managing Workers' Compensation Costs
… governments can get insurance for workers’ compensation in one of four ways: Purchase a policy from a private sector … as authorized by the Workers' Compensation Law Participate in a county self-insurance plan as authorized by the Workers' … salaries to those job classifications. If you participate in the State Insurance Fund or purchase a policy from a …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-managing-workers-compensation-costsRensselaer City School District – Medicaid Reimbursements (2024M-42)
… (District) officials claimed Medicaid reimbursements to which the District was entitled. Key Findings District … submit claims for all Medicaid-eligible services provided to Medicaid-eligible students and did not correct and … claims. The District also lacked adequate procedures to ensure Medicaid claims were submitted and reimbursed. As a …
https://www.osc.ny.gov/local-government/audits/school-district/2024/07/12/rensselaer-city-school-district-medicaid-reimbursements-2024m-42HeartShare Human Services, Inc. – Compliance With the Reimbursable Cost Manual
… focused primarily on expenses claimed on HeartShare’s CFR for the fiscal year ended June 30, 2014 and included certain expenses claimed on its CFRs … 30, 2014, HeartShare reported approximately $38 million in reimbursable costs for the SED preschool cost-based …
https://www.osc.ny.gov/state-agencies/audits/2017/10/24/heartshare-human-services-inc-compliance-reimbursable-cost-manualCredit Cards – Travel and Conference Expense Management
… district may authorize designated employees to use a credit card issued in the name of the local government or school district to pay … frequently to have a local government or school district credit card issued in both the name of the local government … district may authorize designated employees to use a credit card issued in the name of the local government or …
https://www.osc.ny.gov/local-government/publications/travel-conference-expense/credit-cardsReducing the Cost of Hospital Services Provided to County Inmates (2013-MS-4)
… audit was to determine if counties are controlling inmate hospital costs and paying the appropriate rates for the … on a county’s financial resources. For example, inmate hospital health care costs in the eight counties audited … about $1.4 million, or 50 percent, was for inpatient hospital services while $1.4 million, or 50 percent, was for …
https://www.osc.ny.gov/local-government/audits/county/2014/09/19/reducing-cost-hospital-services-provided-county-inmates-2013-ms-4The Child Study Center of New York – Compliance With the Reimbursable Cost Manual
… Background CSC, a not-for-profit organization located in Jericho, New York, is authorized by SED to provide … June 30, 2014, CSC reported approximately $5.9 million in reimbursable costs on its CFR for two rate-based preschool … fiscal year ended June 30, 2014, we identified $127,101 in ineligible costs that CSC reported on its CFR for the …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/child-study-center-new-york-compliance-reimbursable-cost-manualSpringbrook NY, Inc. – Compliance With the Reimbursable Cost Manual
… The audit covered expenses reported on Springbrook’s CFR for the fiscal year ended June 30, 2015. About the Program Springbrook is an SED-approved special education provider located in Otsego County. Springbrook provides, among other programs, …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/springbrook-ny-inc-compliance-reimbursable-cost-manualBuilding Blocks Developmental Preschool, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Building Blocks Developmental … (CFRs) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including … To determine whether the costs reported by Building Blocks Developmental Preschool …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/building-blocks-developmental-preschool-inc-compliance-reimbursable-cost-manualJowonio School – Compliance With the Reimbursable Cost Manual
… to children with disabilities between three and five years of age. Jowonio is reimbursed for preschool special education … $98,572 in personal service costs, which consisted of ineligible employee bonuses; and $19,538 in other than personal service costs, which consisted of $16,656 in insufficiently documented vehicle costs, $2,370 …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/jowonio-school-compliance-reimbursable-cost-manualBehavior Analysts of New York, LLC – Compliance With the Reimbursable Cost Manual
… allowable, properly calculated, and adequately documented in accordance with applicable State Education Department … The audit covered costs reported on BANY’s CFR for the reporting year ended June 30, 2015. About the Program BANY is an SED-approved, …
https://www.osc.ny.gov/state-agencies/audits/2020/01/31/behavior-analysts-new-york-llc-compliance-reimbursable-cost-manualSt. Anne Institute – Compliance With the Reimbursable Cost Manual
To determine whether the costs reported by St Anne Institute on its Consolidated Fiscal Report were properly calculated adequately documented
https://www.osc.ny.gov/state-agencies/audits/2019/12/10/st-anne-institute-compliance-reimbursable-cost-manualBornhava – Compliance With the Reimbursable Cost Manual
… organization located in Buffalo, New York, offers a range of preschool special education services to children with disabilities from birth to five years of age. Bornhava is authorized by SED to provide preschool … $5,182 in other than personal service costs that consisted of non-reimbursable non-audit services, depreciation costs, …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/bornhava-compliance-reimbursable-cost-manualState Agencies Bulletin No. 1956
… Purpose The purpose of this bulletin is to inform agencies of the processing of the taxable fringe benefit CLEFR for 2021. Affected …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1956-certification-licensure-and-exam-fee-reimbursement-clefr-2021State Agencies Bulletin No. 1864
… Purpose The purpose of this bulletin is to inform agencies of the taxable fringe benefit CLEFR for 2020 processing. … PEF: A letter will be sent by the Governor’s Office of Employee Relations to affected PEF participants informing …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1864-certification-licensure-and-exam-fee-reimbursement-clefr-2020