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Medicaid Program – Improper Payments to a Dentist
… The Department's Medicaid Dental Policy and Procedure Code Manual describes the services eligible for Medicaid … office hours. Medicaid had no computer system edits or manual controls to prevent payments of the improper claims …
https://www.osc.ny.gov/state-agencies/audits/2013/07/15/medicaid-program-improper-payments-dentistCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… included in our initial audit report, Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service … with drug manufacturers for rebates and remit the rebate revenue to Civil Service. Our initial audit report, … sought to determine if CVS Health remitted commercial drug rebate revenue related to Empire Plan drug utilization in …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followFranziska Racker Centers, Inc.: Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Franziska Racker … Racker provides preschool special education services to children with disabilities who are 3 to 5 years of age. Racker is reimbursed for these services … To determine whether the costs reported by Franziska Racker …
https://www.osc.ny.gov/state-agencies/audits/2022/02/01/franziska-racker-centers-inc-compliance-reimbursable-cost-manualUnited Cerebral Palsy Association of Nassau County, Inc. – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by United Cerebral … other programs, CPN provides preschool education services to children with disabilities who are 3 to 5 years of age. CPN is reimbursed for these services … To determine whether the costs reported by United Cerebral …
https://www.osc.ny.gov/state-agencies/audits/2022/06/08/united-cerebral-palsy-association-nassau-county-inc-compliance-reimbursable-cost-manualImproper Medicaid Payments for Terminated Drugs (Follow-Up)
… level by the Centers for Medicare & Medicaid Services (CMS). The Medicaid program covers medically necessary … ensure terminated drugs will not be dispensed or paid for, CMS requires state Medicaid programs to reject these claims … was recalled for health and safety reasons). Pursuant to CMS guidelines, the Department maintains drug termination …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/improper-medicaid-payments-terminated-drugs-followField of Dreams, Inc. – Compliance With the Reimbursable Cost Manual
… (SED) guidelines, including the Reimbursable Cost Manual (RCM) and the Consolidated Fiscal Reporting and Claiming Manual (CFR Manual). The audit covered the costs submitted by FOD to SED … Departments guidelines including the Reimbursable Cost Manual and the Consolidated Fiscal …
https://www.osc.ny.gov/state-agencies/audits/2022/10/26/field-dreams-inc-compliance-reimbursable-cost-manualWayne County Chapter NYSARC, Inc. – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by the Wayne County … ARC Wayne provides preschool special education services to children with disabilities who are three and four years of … information, including costs, that ARC Wayne reports to SED on its annual CFR. To be eligible for reimbursement, …
https://www.osc.ny.gov/state-agencies/audits/2020/12/07/wayne-county-chapter-nysarc-inc-compliance-reimbursable-cost-manualMary Cariola Children’s Center, Inc. – Compliance With the Reimbursable Cost Manual
… education services to children with disabilities who are three and four years of age. Mary Cariola is reimbursed … services through rates set by SED. The reimbursement rates are based on financial information, including costs that Mary …
https://www.osc.ny.gov/state-agencies/audits/2020/12/07/mary-cariola-childrens-center-inc-compliance-reimbursable-cost-manualThe Kelberman Center, Inc. – Compliance With the Reimbursable Cost Manual
… is to provide state-of-the-art programs and services for children and adults with Autism Spectrum Disorder and their families through various programs and services. As part of … services provided by a registered public accounting firm, expenses not related to the Promise Program, and …
https://www.osc.ny.gov/state-agencies/audits/2020/12/23/kelberman-center-inc-compliance-reimbursable-cost-manualKids Unlimited, PT, OT & SLP, PLLC – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Kids Unlimited, … (CFRs) were reasonable, necessary, directly related to the special education program, and sufficiently documented … To determine whether the costs reported by Kids Unlimited PT …
https://www.osc.ny.gov/state-agencies/audits/2020/12/31/kids-unlimited-pt-ot-slp-pllc-compliance-reimbursable-cost-manualNew York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members
… eligibility information. Up-to-date enrollment records are necessary to process payments accurately and prevent … as warranted. Take steps to ensure all recoverable claims are identified and pursued for recovery to the fullest extent …
https://www.osc.ny.gov/state-agencies/audits/2021/09/29/new-york-state-health-insurance-program-payments-unitedhealthcare-medicalsurgical-servicesOversight of Industrial Hemp (Follow-Up)
… (THC) concentration of no more than 0.3%. On February 7, 2014, the Agricultural Act of 2014 was signed … needed to improve its monitoring of Program compliance by taking steps to improve the quality of Program data and … 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/2021/07/16/oversight-industrial-hemp-followUtilization of the Arch Street Yard and Shop Facility (Follow-Up)
… Long Island City, adjacent to the No. 7 line Hunters Point Ave. Station. This facility was designed to provide …
https://www.osc.ny.gov/state-agencies/audits/2020/01/28/utilization-arch-street-yard-and-shop-facility-followMedicaid Program – Cost of Pharmacy Services Under Managed Care
… the Department of Health (Department) obtained Medicaid pharmacy services under managed care in an economical manner. … uses two methods to pay health care providers for Medicaid pharmacy services: fee-for-service (FFS) and managed care. Under FFS, the Department pays pharmacy providers directly for each drug dispensed to a …
https://www.osc.ny.gov/state-agencies/audits/2020/09/17/medicaid-program-cost-pharmacy-services-under-managed-careMedicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services (Follow-Up)
… extent of implementation of the three recommendations made in our initial audit report, Medicaid Overpayments for … provides the force needed to deliver air to the lungs in a patient whose ability to breathe is diminished or lost. … 1, 2014 through December 31, 2018. We identified $975,795 in overpayments on 32 inpatient claims that reported 96 …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-services-followNew York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Follow-Up)
… Objective To assess the extent of implementation of the three recommendations included in our initial audit … Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance … To assess the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2023/01/18/new-york-state-health-insurance-program-payments-unitedhealthcare-medicalsurgical-servicesAbilities 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 with disabilities who are between the ages of 3 … To determine whether the costs reported by Abilities First …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/abilities-first-inc-compliance-reimbursable-cost-manualCompliance With Special Education Requirements – Evaluations (Follow-Up)
To determine the extent of implementation of the four recommendations included in our initial audit report Compliance With Special Education Requirements Evaluations Report 2017N3
https://www.osc.ny.gov/state-agencies/audits/2023/03/15/compliance-special-education-requirements-evaluations-followMedicaid Program – Maximizing Drug Rebates Under the Federal Medicaid Drug Rebate Program
… all available drug rebates under the federal Medicaid Drug Rebate Program (MDRP). The audit covered the period from … drugs. The program was later expanded to require rebate collection for certain physician-administered drugs … MDRP requires drug manufacturers to enter into a national rebate agreement with the Centers for Medicare & Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2023/04/05/medicaid-program-maximizing-drug-rebates-under-federal-medicaid-drug-rebate-programCyber Incident Response Team (Follow-Up)
… in our initial audit report, Cyber Incident Response Team (Report 2020-S-58 ). About the Program Cybercrimes … Crime Report. In 2017, the Cyber Incident Response Team (CIRT) was created within the Division of Homeland … in our initial audit report Cyber Incident Response Team Report 2020S58 …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/cyber-incident-response-team-follow