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Oversight of Obesity and Diabetes Prevention Programs
… funds. The Department made overpayments of $5,811 to two contractors. One contractor received $5,751 for personal … Ensure that costs reported by the Department’s network of contractors are supported, appropriate, and reimbursable. …
https://www.osc.ny.gov/state-agencies/audits/2018/09/17/oversight-obesity-and-diabetes-prevention-programsExamination of Unemployment Insurance Willful Overpayments
… overpayment resulting from a willful misrepresentation, a penalty shall be imposed on the claimant. Key Findings We … up to $311,775 in penalties—more than 10 percent of the penalty amount we examined. This includes up to 1,679 … incorrectly, but these recording errors did not affect the penalty amount. We found these errors were caused by either …
https://www.osc.ny.gov/state-agencies/audits/2018/09/25/examination-unemployment-insurance-willful-overpaymentsEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member hospitals. Payments for hospital services are generally based on standard fee …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughMedicaid Claims Submitted by Accordis, Inc. on Behalf of the New York City Health and Hospitals Corporation
… Purpose To determine whether Accordis Inc. submitted appropriate … Background Healthcare providers submit Medicaid claims to the Department of Health’s eMedNY claims processing system … Claims that are denied can be modified and resubmitted to eMedNY for payment. Medicaid allows healthcare billing …
https://www.osc.ny.gov/state-agencies/audits/2013/03/12/medicaid-claims-submitted-accordis-inc-behalf-new-york-city-health-and-hospitalsBenefit Eligibility Assessment Process
… Purpose To determine whether the New York City Human Resources … (Client) eligibility, and when a Client is determined to be ineligible, denying, reducing or terminating the Client's benefits. As a last resort, Clients deemed to be ineligible are entitled to a Fair Hearing administered …
https://www.osc.ny.gov/state-agencies/audits/2014/05/28/benefit-eligibility-assessment-processSchool of Professional Studies – Controls Over Bank Accounts
… internal controls over bank accounts held in the school’s name. Consequently, a former CUNY SPS employee had complete … and use them to open two unauthorized bank accounts in the name of CUNY SPS. As of the end of our audit fieldwork, …
https://www.osc.ny.gov/state-agencies/audits/2015/06/02/school-professional-studies-controls-over-bank-accountsContracts for Personal and Miscellaneous Services (Follow-Up)
… Purpose To determine the extent of implementation of the four … Authority’s (MTA) constituent agencies are required to determine whether services can be provided in-house before proceeding to contract, the agencies were not required to maintain … To determine the extent of implementation of the four …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/contracts-personal-and-miscellaneous-services-followMedicaid Payments for Excessive Dental Services (Follow-Up)
… our initial audit report, Medicaid Payments for Excessive Dental Services (Report 2009-S-46). Background Our initial … on August 16, 2010, examined Medicaid payments for routine dental services, such as cleanings and oral evaluations, … 31, 2009. Our audit identified $40 million of excessive dental services that exceeded certain frequency limits (i.e., …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/medicaid-payments-excessive-dental-services-followAssessment of Costs to Administer the Workers’ Compensation Program for the Two Fiscal Years Ended March 31, 2013
… and self-insured political subdivisions of the State. Key Findings The Board has adequate procedures in …
https://www.osc.ny.gov/state-agencies/audits/2015/04/15/assessment-costs-administer-workers-compensation-program-two-fiscal-years-ended-march-31Selected Aspects of Discretionary Spending
… Operating Corporation of the State of New York (RIOC) is a public benefit corporation and a political subdivision … increases the risk that not all discretionary spending is necessary and appropriate for the mission of the … discretionary spending and discontinue any spending that is not consistent with RIOC’s mission. Establish written …
https://www.osc.ny.gov/state-agencies/audits/2014/09/30/selected-aspects-discretionary-spending-3Accuracy of Reported Cost Savings
… Purpose To assess the accuracy of the Office of the Medicaid … of the Medicaid Inspector General's (OMIG) mission is to enhance the integrity of the New York State Medicaid … detecting fraudulent, abusive and wasteful practices, and to recover improperly expended Medicaid funds while promoting …
https://www.osc.ny.gov/state-agencies/audits/2014/07/11/accuracy-reported-cost-savingsEducators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)
… the 3 recs included in our initial audit report Educators for Children Youth Families Inc Use of Contract Funds …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/educators-children-youth-and-families-inc-use-contract-funds-followAssessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… to Administer the Workers’ Compensation Program for the Two Fiscal Years Ended March 31, 2013 (2014-S-43) Workers’ …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Accounts Payable Advisory No. 70
… Subject : Emergency Check Production Reference : Guide to Financial Operations (GFO), Chapter XII, Section 5.M – … : New York State entered into a contract with Key Bank to print and mail checks paid from the State’s general … checks) if the State’s check printing facilities close due to an emergency. In such an event, the State will process …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/70-producing-checks-emergency-eventAllocation, 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-securityChildren's Development Group, PLLC – Compliance With the Reimbursable Cost Manual
… reported on CDG’s CFR for the reporting year ended June 30, 2016. About the Program CDG is an SED-approved, … (RCM) requirements. For the reporting year ended June 30, 2016, CDG reported $427,599 in reimbursable costs for its … counties Key Findings For the reporting year ended June 30, 2016, we identified $166,676 in reported costs that did …
https://www.osc.ny.gov/state-agencies/audits/2019/12/11/childrens-development-group-pllc-compliance-reimbursable-cost-manualEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… To determine whether Empire BlueCross properly paid hospital claims for intraocular procedures. The audit covered … million members. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsOversight of Nurse Hiring and Retention (Follow-Up)
… issuance of the follow-up review to provide information on any actions that are planned to address the unresolved …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/oversight-nurse-hiring-and-retention-followBehavior 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 Advantage Plan Services (Follow-Up)
… needs of Medicare enrollees. When a health care service is covered by a Medicaid recipient’s Plan, Medicaid is generally the secondary payer and reimburses providers for … in the initial audit report; however, additional action is needed. In particular, the Office of the Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-follow