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Medicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… Objective To determine whether the Department of Health (DOH) provided adequate oversight to ensure managed care recipients in the Recipient Restriction Program received … (Restriction Program) was created to reduce the cost of inappropriate utilization by identifying Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientUtilization of the Arch Street Yard and Shop Facility
… and inspection facility for its new M-7 electric rail cars, which Bombardier began delivering in 2002. According to … as intended for the acceptance and inspection of the M-7 cars. Moreover, except for occasional use of the wheel truing … to perform modifications on Metro-North Railroad rail cars. The LIRR incurred costs of $2.43 million to maintain …
https://www.osc.ny.gov/state-agencies/audits/2017/12/08/utilization-arch-street-yard-and-shop-facilityMedicaid Program – Inappropriate Payments Related to Procedure Modifiers
… by the provider. This is commonly known as the global surgery period. All routine services related to the surgery, … for E/M services billed without a modifier code on the same day a surgical procedure was performed. The payments were …
https://www.osc.ny.gov/state-agencies/audits/2018/04/17/medicaid-program-inappropriate-payments-related-procedure-modifiersMedicaid Program – Maximizing Drug Rebates for Health and Recovery Plans
… drugs, to Medicaid recipients age 21 or older with serious mental illness and/or substance use disorders. Beginning on October …
https://www.osc.ny.gov/state-agencies/audits/2018/06/22/medicaid-program-maximizing-drug-rebates-health-and-recovery-plansImproper Payments to a Physical Therapist (Follow-Up)
… of the two recommendations included in our initial audit report, Improper Payments to a Physical Therapist ( Report 2013-S-15 ). Background The State’s Medicaid program … of the two recommendations included in our initial audit report Improper Payments to a Physical Therapist Report 201 …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followMedicaid Program – Appropriateness of Medicaid Eligibility Determined by the New York State of Health System
… adequate controls to ensure accurate enrollments in the Medicaid program and to determine whether improper enrollments caused Medicaid overpayments. The audit covered the period October … individuals to obtain health insurance coverage, including Medicaid. Individuals who apply for public assistance …
https://www.osc.ny.gov/state-agencies/audits/2015/10/28/medicaid-program-appropriateness-medicaid-eligibility-determined-new-york-state-healthOverpayments 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-followReporting and Utilization of Bias Incident Data
… To determine whether the New York City Police Department NYPD is accurately collecting recording and …
https://www.osc.ny.gov/state-agencies/audits/2014/09/25/reporting-and-utilization-bias-incident-dataExamination of Unemployment Insurance Benefits
… The results contained in our report cover select high risk payment requests and payments DOL processed from January 1, … prior years’ payments associated with those high risk payment requests and payments, and prior years’ findings … during in 2013. Key Findings We identified 7,370 erroneous payment totaling more than $2 million. This includes $728,493 …
https://www.osc.ny.gov/state-agencies/audits/2014/06/09/examination-unemployment-insurance-benefitsLow-Income Housing Trust Fund Program
… Purpose To determine whether Low-Income Housing Trust Fund Program (Program) funds are being awarded … manner to help meet the State's critical low-income housing needs. The audit covers the period April 1, 2008 through December 11, 2013. Background The Housing Trust Fund Corporation's (Corporation) mission is to …
https://www.osc.ny.gov/state-agencies/audits/2014/08/28/low-income-housing-trust-fund-programRailroad Bridge Inspection Program
… in the State to ensure they meet the bridge inspection requirements. This audit covers the period January 1, 2010 … railroads comply with its bridge inspection and reporting requirements. For example, the bridge management plans on … in the State to ensure they meet the bridge inspection requirements …
https://www.osc.ny.gov/state-agencies/audits/2013/12/09/railroad-bridge-inspection-programMonitoring and Administration of Public Protection Grant Programs (Follow-Up)
… of Public Protection Grant Programs ( 2019-S-21 ). About the Program The Division’s mission is to enhance …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/monitoring-and-administration-public-protection-grant-programs-followCareer and Technical Education
… CTE programs; and accurately collecting and reporting CTE placement data. The audit covered school years 2015-16 … programs; and ensure State plans measure post-graduation placement. Key Findings DOE could not show how existing CTE … or attend. DOE does not currently report post-secondary placement data for CTE students, as required by the State …
https://www.osc.ny.gov/state-agencies/audits/2021/05/20/career-and-technical-educationMedicaid Program – Claims Processing Activity April 1, 2020 Through September 30, 2020
… 7, 2015. About the Program The Department administers the State’s Medicaid program. The Department’s eMedNY computer … prior to, but billed during, the Coronavirus Disease state of emergency that would have been denied had certain …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-claims-processing-activity-april-1-2020-through-september-30-2020Anthem Blue Cross – Coordination of Benefits With Medicare
… Empire Plan members with Medicare coverage. The audit covered the period from January 2020 through June 2023. About the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of … use for paying health care claims when people are covered by more than one insurance plan. This process …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareMedicaid Program – Improper Medicaid Payments for Childhood Vaccines
… at a discount and distributes the vaccines to state health departments and certain local and territorial …
https://www.osc.ny.gov/state-agencies/audits/2018/12/06/medicaid-program-improper-medicaid-payments-childhood-vaccinesErrors in Identification of 340B Providers in the Medicaid Drug Rebate Program (Follow-Up)
… the implementation status of the four recommendations made in our initial audit report, Errors in Identification of 340B Providers in the Medicaid Drug Rebate Program (Report 2016-S-6 ). … the implementation status of the four recommendations made in our initial audit report Errors in Identification of 340B …
https://www.osc.ny.gov/state-agencies/audits/2018/10/23/errors-identification-340b-providers-medicaid-drug-rebate-program-followRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… compliance. The Law does not preclude nurses from volunteering to work additional hours and does not apply in … audit report. Of the five prior audit recommendations, one was implemented and four were partially implemented. Key …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-followComptroller DiNapoli Releases School Audits
… and local funds. For additional background or a comment on a specific audit, please contact Brian Butry at …
https://www.osc.ny.gov/press/releases/2016/11/comptroller-dinapoli-releases-school-audits-2Earnings Limits – Enhanced Reporting
… above the limit. Earnings Period Earnings Limit April 1, 2026 – March 31, 2027 $360,000 April 1, 2025 – March 31, 2026 $350,000 April 1, 2024 – March 31, 2025 $345,000 April … Earnings Period Earnings Limit April 1, 2025 – March 31, 2026 $250,000 April 1, 2024 – March 31, 2025 $250,000 April …
https://www.osc.ny.gov/retirement/employers/enhanced-reporting/earnings-limits