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Medicaid 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 …
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 … as follows: $10.2 million was paid for managed care premiums on behalf of Medicaid recipients who also had …
https://www.osc.ny.gov/state-agencies/audits/2023/05/11/medicaid-program-claims-processing-activity-april-1-2022-through-september-30-2022Rensselaer City School District – Medicaid Reimbursements (2024M-42)
… Key Findings District officials did not submit claims for all Medicaid-eligible services provided to … requirements are met to submit Medicaid claims for reimbursement for all eligible services provided. Review all unclaimed services and submit any eligible claims for reimbursement. Correct and resubmit rejected claims for …
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 … ineligible employee bonuses that did not comply with SED’s reimbursement requirements; $201,237 in over-allocated … The compensation for the three executives exceeded SED’s reimbursement limits for the preschool cost-based programs; …
https://www.osc.ny.gov/state-agencies/audits/2017/10/24/heartshare-human-services-inc-compliance-reimbursable-cost-manualCost-Saving Ideas: Managing Workers' Compensation Costs
… a mandatory benefit. Local governments can get insurance for workers’ compensation in one of four ways: Purchase a … on various factors such as employee wages, level of risk for each job classification and your experience rating. You … different categories of risk, you could be paying more in premiums than is warranted. If your local government …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-managing-workers-compensation-costsReducing the Cost of Hospital Services Provided to County Inmates (2013-MS-4)
… inmate hospital costs and paying the appropriate rates for the services provided for the period January 1 through … claims to the federal government for up to 50 percent reimbursement. There is no law that sets the amounts that … counties did not submit claims seeking potential federal reimbursement of up to $46,352 for inpatient medical services …
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
… (RCM). The audit covered expenses reported on CSC’s CFR for the fiscal year ended June 30, 2014. Background CSC, a … special education services through rates set by SED. These reimbursement rates are based on financial information, … CSC reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …
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 … for these services through rates set by SED. The reimbursement rates are based on financial information, … reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/springbrook-ny-inc-compliance-reimbursable-cost-manualBornhava – Compliance With the Reimbursable Cost Manual
… year ended June 30, 2014. Background Bornhava, a not-for-profit organization located in Buffalo, New York, offers … for these services through rates set by SED. The reimbursement rates are based on financial information, … reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with RCM …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/bornhava-compliance-reimbursable-cost-manualJowonio School – Compliance With the Reimbursable Cost Manual
… The audit covered expenses reported on Jowonio’s CFR for the fiscal year ended June 30, 2014, and certain expenses … special education services through rates set by SED. These reimbursement rates are based on financial information, … reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/jowonio-school-compliance-reimbursable-cost-manualBuilding Blocks Developmental Preschool, Inc. – Compliance With the Reimbursable Cost Manual
… audit covered expenses reported on Building Blocks’ CFR for the fiscal year ended June 30, 2015, and certain expenses … special education services through rates set by SED. These reimbursement rates are based on financial information, … reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/building-blocks-developmental-preschool-inc-compliance-reimbursable-cost-manualBehavior Analysts of New York, LLC – Compliance With the Reimbursable Cost Manual
… The audit covered costs reported on BANY’s CFR for the reporting year ended June 30, 2015. About the Program … BANY reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with SED’s … with SED requirements and are therefore not eligible for reimbursement. The $2,082 included $1,134 in personal service …
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
… The audit covered expenses reported on St. Anne’s CFR for the fiscal year ended June 30, 2016. About the Program … for these services through rates set by SED. The reimbursement rates are based on financial information, … Anne reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …
https://www.osc.ny.gov/state-agencies/audits/2019/12/10/st-anne-institute-compliance-reimbursable-cost-manualCredit Cards – Travel and Conference Expense Management
… the name of the local government or school district to pay for certain travel and conference expenses. This can be … attach their original credit card receipts to their travel reimbursement claim. Original charge receipts should be submitted for audit before any reimbursement claim may be paid. Credit cards issued for …
https://www.osc.ny.gov/local-government/publications/travel-conference-expense/credit-cardsState Agencies Bulletin No. 1864
… is to inform agencies of the taxable fringe benefit CLEFR for 2020 processing. Affected Employees Employees who … in the PEF or CSEA Certification, Licensure and Exam Fee Reimbursement Program or who used Empire Star Public Service … benefits such as the Certification, Licensure and Exam Fee Reimbursement are considered taxable income. Effective Dates …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1864-certification-licensure-and-exam-fee-reimbursement-clefr-2020State Agencies Bulletin No. 1956
… of the processing of the taxable fringe benefit CLEFR for 2021. Affected Employees Employees who participated in the PEF or CSEA Certification, Licensure, and Exam Fee Reimbursement Program, or who used Empire Star Public Service … such as the Certification, Licensure, and Exam Fee Reimbursement are considered taxable income. Effective Dates …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1956-certification-licensure-and-exam-fee-reimbursement-clefr-2021Maintenance and Tuition Payments to the Lake Grove School and Mountain Lake Children's Residence
… by Lake Grove and Mountain Lake to establish daily reimbursement rates for services provided to their respective residents. During … in inappropriate and/or unsupported costs claimed for reimbursement by these facilities. Such costs included …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/maintenance-and-tuition-payments-lake-grove-school-and-mountain-lake-childrens-residenceTheraCare Preschool Services, Inc. – Compliance With the Reimbursable Cost Manual
… which detail program-related expenses. To be eligible for reimbursement, the provider's reported expenses must … to costs reported on the CFRs and to TheraCare's tuition reimbursement rates, and recover the overpayments, as …
https://www.osc.ny.gov/state-agencies/audits/2014/04/02/theracare-preschool-services-inc-compliance-reimbursable-cost-manualAudit of the Tuition Reimbursement Account for the Five Fiscal Years Ended March 31, 2018 (2019-S-3)
To express an opinion on the fair presentation of the Financial Statements of the Tuition Reimbursement Account for the five fiscal years ended March 31, 2018.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-19s3.pdfLisbon Central School District – Medicaid Reimbursements (2022M-180)
… services from the District or file Medicaid reimbursement claims to recover part of the costs associated … As a result, the District did not receive about $20,000 for reimbursements to which it was likely entitled. Although … provided. Key Recommendations Consider submitting Medicaid reimbursement claims. Establish written Medicaid claim …
https://www.osc.ny.gov/local-government/audits/school-district/2023/01/27/lisbon-central-school-district-medicaid-reimbursements-2022m-180