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Subway Service Diversions for Maintenance and Capital Projects (Follow-Up)
… in our initial audit report, Subway Service Diversions for Maintenance and Capital Projects ( 2010-S-34 ). … that while Transit has a number of policies and procedures for managing and controlling subway diversions, more needed … not planned using current ridership data, and the budget for diversion advertisements to communicate information about …
https://www.osc.ny.gov/state-agencies/audits/2015/09/16/subway-service-diversions-maintenance-and-capital-projects-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… our initial audit report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of … adjudicates a claim, Medicaid pays the balance that is not covered by Medicare and would otherwise be the financial … generally would pay deductibles and coinsurance not covered by Medicare. Our initial audit report, which was …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… of the five recommendations made in our audit report, Unnecessary Medicaid Payments for Children at Voluntary Agencies (2010-S-47). Background Our initial audit report, which was issued on September 19, 2012, examined … of the five recommendations made in our audit report Unnecessary Medicaid Payments for Children at …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… extent of implementation of the five recommendations made in our audit report, Improper Managed Care Payments for … years ended June 30, 2010, Medicaid made $15.6 million in improper managed care payments on behalf of 14,899 … who, by State law, were precluded from enrollment in managed care programs. We recommended that the Department …
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… range of services including, but not limited to, hospital services, office visits, home care, medical … rate schedules for the payment of inpatient and outpatient hospital services. Empire’s hospital contracts also allow … Empire BlueCross BlueShield - Payments Made to Hudson Valley Hospital Center (2009-S-99) New York Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… Objective To determine the extent of implementation of the 11 recommendations made in our initial audit report, Improper … We issued our initial audit report on December 11, 2018. The audit objective was to determine whether … future Medicaid overpayments. Of the initial report’s 11 audit recommendations, 1 was implemented, 3 were partially …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
To determine whether UnitedHealthcare paid claims using reasonable and customary reimbursement rate schedules that did not correlate
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… drugs, to Medicaid recipients age 21 or older with serious mental illness and/or substance use disorders. We issued our initial …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/maximizing-drug-rebates-health-and-recovery-plans-followEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… Medicaid managed care organizations inappropriately paid for durable medical equipment beyond allowed rental limits, and whether the Medicaid program could achieve … audit covered the period from July 2016 to December 2021 for non-oxygen-related durable medical equipment rentals and …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
… included in our initial audit report, Improper Managed Care Payments for Misclassified Patient Discharges (Report … recipients receive their medical services through managed care, whereby the Department pays managed care organizations (MCOs) a monthly premium for each enrolled …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followAnnual Assessment of Market Orders for 2015 and 2016
… 2014 through June 30, 2016 for the Apple and Sour Cherry Market Orders and the period April 1, 2014 through March 31, … the Program During the audit period, the Department’s Market Order Administration was responsible for the … the Apple Market Order and the New York Apple Association, Inc. (NYAA) contract. The Department did not always enforce …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/annual-assessment-market-orders-2015-and-2016Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services
… Hospitals use International Classification of Diseases (ICD) procedure codes on their claims to report mechanical … ventilation services. When hospitals use a specific ICD procedure code to report a patient received 96 … for 4,874 inpatient APR-DRG claims that included an ICD procedure code for 96 consecutive hours or more of …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-servicesMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… Part C, private managed care companies administer Medicare benefits and offer different health care plans (referred to … services that are not covered by original Medicare (e.g., dental services). Plans reimburse health care providers for … If Plans deny a claim or pay a different amount than what a provider billed, Plans must communicate the reasons …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesRestrictions 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-followImplementation of the Dignity for All Students Act (Follow-Up)
… of implementation of the three recommendations included in our initial audit report, Implementation of the Dignity … for All Students Act (DASA) seeks to provide students in New York with a safe and supportive environment free from … included curriculum and annual reporting requirements in 12 bias-related categories (e.g., race, sexual …
https://www.osc.ny.gov/state-agencies/audits/2019/11/21/implementation-dignity-all-students-act-followDiNapoli: IDA Audits Reveal Need For Improved Project Oversight
… Industrial Development Agencies (IDAs) in Niagara , Tompkins and Wyoming counties failed to … said DiNapoli. “IDAs are leveraging tax breaks in exchange for long-term jobs and future revenue for their communities, but without adequate safeguards in place the effectiveness of these efforts cannot be …
https://www.osc.ny.gov/press/releases/2015/09/dinapoli-ida-audits-reveal-need-improved-project-oversightBrighter Choice Charter School for Boys - Payroll (2018M-139)
… Brighter Choice Charter School for Boys Payroll 2018M139 …
https://www.osc.ny.gov/local-government/audits/charter-school/2018/10/12/brighter-choice-charter-school-boys-payroll-2018m-139DiNapoli Announces State Contract and Payment Actions for November
… $5.5 million with Mountain Candy & Cigar Company, Inc. and $5.5 million with North Shore Bottling, Inc. $5.6 million with Ryder Truck Rental, Inc. for truck leases and preventative maintenance services …
https://www.osc.ny.gov/press/releases/2016/12/dinapoli-announces-state-contract-and-payment-actions-novemberDiNapoli Announces State Contract & Payment Actions for February 2015
… steel members on Castleton Bridge. $11.2 million with Cold Spring Construction Co. for removal and construction of …
https://www.osc.ny.gov/press/releases/2015/03/dinapoli-announces-state-contract-payment-actions-february-2015