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Medicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services (2017-S-46) 90-Day Response
To determine if the Department of Health overpaid health care providers’ Medicaid claims for services also covered by Medicare Advantage plans.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s46-response.pdfImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (2018-S-71) 180-day response
To determine whether Medicaid made improper payments to providers on behalf of dual-eligible individuals receiving hospice care covered by Medicare.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-18s71-response.pdfCost-Saving Ideas: Minimizing Unemployment Insurance Costs
… You can take steps to reduce the cost of unemployment insurance, which provides short-term … who become unemployed through no fault of their own. The New York State Department of Labor (DOL) determines who … unemployment insurance, DOL will determine whether or not the employee is eligible for benefits. If they are, DOL will …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-minimizing-unemployment-insurance-costsRecovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance (Follow-Up)
… of implementation of the six recommendations included in our initial audit report, Medicaid Program: Recovering … (MCOs) a monthly premium for each enrolled recipient and, in turn, MCOs are required to pay for the Medicaid services … Many recipients have other third-party health insurance in addition to Medicaid (e.g., employer-based coverage or …
https://www.osc.ny.gov/state-agencies/audits/2024/01/31/recovering-managed-care-overpayments-pharmacy-services-behalf-recipients-third-party-healthBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… Compliance With the Reimbursable Cost Manual ( 2015-S-19 ) New York League for Early Learning, Inc.: Compliance With the …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualXIII.5 Alternatives to the State Travel Card – XIII. Employee Expense Reimbursement
… expenses. Alternatives exist for paying necessary lodging and transportation expenses, including but not limited to: … through the SFS AP module. Using OGS travel agents and transportation contract service providers. The State pays …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xiii/xiii5-alternatives-state-travel-cardMedicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
… methodology in an effort to pay providers more accurately for their services. APG claims are reimbursed based on patient condition and complexity of service. The Department phased in the APG methodology … Recommendations Review the overpayments we identified and make recoveries as appropriate. Strengthen controls over APG …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-ambulatory-patient-groups-payments-duplicate-claims-and-services-excessPayments Allowed in Advance of Audit – Improving the Effectiveness of Your Claims Auditing Process
… be audited as soon as possible after payment and included on the next abstract as prepaid amounts. Public utility …
https://www.osc.ny.gov/local-government/publications/claims-auditing-process/payments-allowed-advance-auditFamily and Educational Consultants – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Family and … County. FEC provides preschool special education services to children with disabilities who are between three and five …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/family-and-educational-consultants-compliance-reimbursable-cost-manualKinderwise Learning Associates, LLC – Compliance With the Reimbursable Cost Manual
… for preschool special education services through rates set by SED. The reimbursement rates are based on financial information, including costs, … Kinderwise’s CFR and to Kinderwise’s tuition reimbursement rates. Remind Kinderwise officials of the pertinent SED …
https://www.osc.ny.gov/state-agencies/audits/2018/10/23/kinderwise-learning-associates-llc-compliance-reimbursable-cost-manualWayne County Chapter NYSARC, Inc. – Compliance With the Reimbursable Cost Manual
… Program ARC Wayne is a not-for-profit organization located in Wayne County. Among other programs, ARC Wayne provides … June 30, 2017, ARC Wayne reported approximately $3 million in reimbursable costs on its CFR for the Preschool Special … the fiscal year ended June 30, 2017, we identified $20,988 in ineligible costs that ARC Wayne reported on its CFRs for …
https://www.osc.ny.gov/state-agencies/audits/2020/12/07/wayne-county-chapter-nysarc-inc-compliance-reimbursable-cost-manualThe Kelberman Center, Inc. – Compliance With the Reimbursable Cost Manual
… properly calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, … expenses reported on Kelberman’s 2016 and 2017 CFRs for the fiscal year ended June 30, 2017. About the Program … is an SED-approved special education provider located in Utica. Kelberman’s mission is to provide state-of-the-art …
https://www.osc.ny.gov/state-agencies/audits/2020/12/23/kelberman-center-inc-compliance-reimbursable-cost-manualFunctional MDS – Compliance With the Reimbursable Cost Manual
… the State Education Department’s (SED) Reimbursable Cost Manual (Manual). Our audit included all expenses claimed for the … for reimbursement, provider costs must comply with the Manual, which provides guidance to special education …
https://www.osc.ny.gov/state-agencies/audits/2014/12/31/functional-mds-compliance-reimbursable-cost-manualAdirondack Helping Hands, Inc. – Compliance With the Reimbursable Cost Manual
… for-profit special education provider located in Clinton County, New York. Adirondack provides preschool … year ended June 30, 2014, Adirondack reported $1.1 million in reimbursable costs on its CFR for the rate-based preschool … the fiscal year ended June 30, 2014, we identified $37,643 in ineligible costs that Adirondack reported on its CFR for …
https://www.osc.ny.gov/state-agencies/audits/2017/08/02/adirondack-helping-hands-inc-compliance-reimbursable-cost-manualBilingual Care, Inc. – Compliance With the Reimbursable Cost Manual
… 2014-15 school year, Bilingual served about 171 students in its SEIT program. In addition to the SEIT cost-based program, Bilingual … 30, 2015, Bilingual reported approximately $8.9 million in reimbursable costs for the SEIT cost-based program. Key …
https://www.osc.ny.gov/state-agencies/audits/2019/09/11/bilingual-care-inc-compliance-reimbursable-cost-manualTravel Advisory No. 15
… Please see below for additional information. AC 132-S Certification Signature: In accordance with GFO Chapter XIII, Section 2.C –Expense Report Certification , employees must certify on an expense report … meet this requirement, employees may be required to sign a certification form such as the AC 132-S , Employee Report of …
https://www.osc.ny.gov/state-agencies/advisories/travel-advisory/15-covid-19-travel-and-expense-temporary-exceptionsAbilities First, Inc. – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Abilities First, … region. Among other programs, AFI is authorized by SED to provide preschool special education services to children …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/abilities-first-inc-compliance-reimbursable-cost-manualField of Dreams, Inc. – Compliance With the Reimbursable Cost Manual
… education provider located in Slate Hill, serving students from Orange and Ulster counties. FOD provides special …
https://www.osc.ny.gov/state-agencies/audits/2022/10/26/field-dreams-inc-compliance-reimbursable-cost-manualJCC of Mid-Westchester – Compliance With the Reimbursable Cost Manual
… and compensation from a prior year; and $63,977 in other than personal service costs that consisted of non-allowable …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/jcc-mid-westchester-compliance-reimbursable-cost-manualWestchester Community Opportunity Program, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Westchester … WestCOP provides preschool special education services to children with disabilities who are between three and five …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/westchester-community-opportunity-program-inc-compliance-reimbursable-cost-manual