Search
Claims Processing Activity April 1, 2019 Through September 30, 2019 (2019-S-12) 180-Day Response
To determine whether the Department of Health’s (Department) eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s12-response.pdfOversight of Provider Consolidated Fiscal Reports – Independent Living, Inc. (2019-S-60) 180-Day Response
To determine whether the Office of Mental Health ensures that costs reported by providers such as Independent Living, Inc. on Consolidated Fiscal Reports are allowable, properly calculated, and adequately documented in accordance with Consolidated Fiscal Reporting and Claiming Manual requirements.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/2020-19s60-response.pdfImproper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (Follow-Up) (2020-F-9) 30-day response
To determine the extent of implementation of the two recommendations made in our initial audit report, Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (Report 2017-S-85).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-20f9-response.pdfImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up) (2019-F-59) 30-day response
To determine the extent of implementation of the 11 recommendations made in our initial audit report, Improper Medicaid Payments for Recipients in Hospice Care (2017-S-76).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-19f59-response.pdfThrough Ages, Inc. - Compliance With the Reimbursable Cost Manual (2019-S-56) 180-Day Response
To determine whether the costs reported by Through Ages, Inc. on its Consolidated Fiscal Reports were reasonable, necessary, directly related to the special education program, and sufficiently documented pursuant to the State Education Department’s Reimbursable Cost Manual and the Consolidated ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s56-response.pdfMarie Pense, LLC - Compliance With the Reimbursable Cost Manual (2019-S-36) 180-Day Response
To determine whether the costs reported by Marie Pense Center, LLC on its Consolidated Fiscal Reports (CFRs) were reasonable, necessary, directly related to...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s36-response.pdfSt. Anne Institute – Compliance With the Reimbursable Cost Manual (2019-S-20) 180-Day Response
To determine whether the costs reported by St. Anne Institute (St. Anne) on its Consolidated Fiscal Report (CFR) were properly calculated, adequately ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s20-response_0.pdfLeague Treatment Center - Compliance With the Reimbursable Cost Manual (2018-S-56) 180-Day Response
To determine whether the costs reported by League Treatment Center (LTC) on its Consolidated Fiscal Reports (CFR) were reasonable, necessary, directly...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-18s56-response.pdfUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims (2018-S-60) 180-Day Response
To determine whether UnitedHealthcare (United) paid claims using reasonable and customary (R&C) reimbursement rate schedules that did not correlate with the...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-18s60-response.pdfBlock Institute School - Compliance With the Reimbursable Cost Manual (2018-S-69) 180-Day Response
To determine whether the costs reported by Block Institute School on its Consolidated Fiscal Reports (CFRs) were reasonable, necessary, directly related to...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-18s69-response.pdfResponsiveness to Noise Complaints Related to Construction Projects (Follow-Up) (2019-F-37) 30-Day Response
To determine the extent of implementation of the recommendations in our initial audit report, Responsiveness to Noise Complaints Related to Construction...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19f37-response.pdfMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up) (2019-F-41) 30-Day Response
To determine the extent of implementation of the two recommendations made in our initial audit report, Maximizing Drug Rebates for Health and Recovery Plans...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19f41-response.pdfOperational Training and Medical Assessments of Train Crews (Follow-Up) (2019-F-18) 30-Day Response
To determine the extent of implementation of the three recommendations included in our initial report, Operational Training and Medical Assessments of Train...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19f18-response.pdfOperational Training and Medical Assessments of Train Crews (Follow-Up) (2019-F-17) 30-Day response
To determine the extent of implementation of the five recommendations included in our initial report, Operational Training and Medical Assessments of Train...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19f17-response.pdfBilingual Care, Inc. – Compliance With the Reimbursable Cost Manual (2018-S-51) 90-Day Response
To determine whether the costs reported by Bilingual Care, Inc. (Bilingual) on its Consolidated Fiscal Reports (CFR) were reasonable, necessary, directly...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18s51-response.pdfSpringbrook NY, Inc. – Compliance With the Reimbursable Cost Manual (2018-S-63) 90-Day Response
To determine whether the costs reported by Springbrook NY, Inc. on its Consolidated Fiscal Report were properly calculated, adequately documented ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18s63-response.pdfFinancial Oversight of the Advantage After School Program (Follow-Up) (2019-F-27) 30-Day Response
To determine the extent of implementation of the two recommendations included in our initial audit report, Financial Oversight of the Advantage After School ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-19f27-response.pdfMedicaid Program - Managed Care Organizations: Payments to Ineligible Providers (Follow-Up) (2019-F-2) 30-Day Response
To determine the extent of implementation of the eight recommendations made in our initial audit report, Managed Care Organizations: Payments to Ineligible Prov
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-19f2-response.pdfAmerimed Kids, LLC - Compliance With the Reimbursable Cost Manual (2018-S-17) 90-Day Response
To determine whether the costs reported by Amerimed Kids, LLC (Amerimed Kids) on its Consolidated Fiscal Reports (CFRs) were reasonable, necessary, directly...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18s17-response.pdfMedicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services (2018-S-45) 90-Day Response
To determine whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on APR-DRG ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18s45-response.pdf