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Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… hospitals do not have such limitations. From January 1, 2011 to March 31, 2011, Empire paid $24 million for 12,990 claims for special …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughAdoption Subsidy Program (Follow-Up)
… Purpose To determine the extent of implementation of the two … 18, 2010, examined whether adoption subsidy payments to adoptive parents were supported and in compliance with … (OCFS) established the Adoption Subsidy Program (Program) to locate and maintain stable and permanent alternative homes …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/adoption-subsidy-program-followMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background Our initial … nursing home claims submitted to Medicaid for hospital bed reserve days were appropriate, and if not, to what extent nursing home claims exceeded the bed reserve day limits. During the five year audit period …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followSelected Operating and Administrative Practices of the Bureau of Narcotic Enforcement (Follow-Up)
… the bulk of which was not provided until June and July 2015. In addition, some of the information that we requested …
https://www.osc.ny.gov/state-agencies/audits/2015/09/23/selected-operating-and-administrative-practices-bureau-narcotic-enforcement-followForensic Audit of Payments to On-Board Service Managers (Follow-Up)
… and time and attendance. In addition, the Assistant Vice President responsible for the Unit violated Metro-North …
https://www.osc.ny.gov/state-agencies/audits/2016/01/21/forensic-audit-payments-board-service-managers-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… bridge defects. Instead, the Authority followed its own methods, but did not always comply with the Department’s …
https://www.osc.ny.gov/state-agencies/audits/2016/06/30/inspecting-highway-bridges-and-repairing-defects-followPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… initial audit report, Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). … from the prescribers (the physicians indicated on the claims), auditors determined that Davis Ethical likely fabricated nearly all of the improper claims. Davis Ethical processed many of the improper claims …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followHousing Preferences for Veterans (Follow-Up)
… included in our initial audit report, Housing Preferences for Veterans (Report 2011-N-3 ). Background Our initial … State Legislature had extended the right of preference for housing to many more veterans, few actually benefited due … included in our initial audit report Housing Preferences for Veterans Report 2011N3 …
https://www.osc.ny.gov/state-agencies/audits/2015/01/29/housing-preferences-veterans-followRainbow Rhymes Learning Center (Follow-Up)
… State Education Department: Rainbow Rhymes Learning Center (Report 2009-S-84). Background Our initial audit … (Department) grant payments to Rainbow Rhymes Learning Center (Rainbow) were appropriate and adequately supported. … State Education Department: Rainbow Rhymes Learning Center Report (2009-S-84) …
https://www.osc.ny.gov/state-agencies/audits/2013/06/27/rainbow-rhymes-learning-center-followAccuracy of Reported Discharge Data (Follow-Up)
… when we examined DoE’s discharge classifications for its 2004-08 general education cohort (i.e., the students …
https://www.osc.ny.gov/state-agencies/audits/2014/09/09/accuracy-reported-discharge-data-followTravel Plaza Revenues and Capital Improvements (Follow-Up)
… Purpose To determine the extent of implementation of the eight … which was issued on January 15, 2010, our objective was to determine whether the New York State Thruway Authority … contracts. We found that the NYSTA's efforts were adequate to ensure fuel and food concessionaires pay full rent on time …
https://www.osc.ny.gov/state-agencies/audits/2014/08/14/travel-plaza-revenues-and-capital-improvements-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… Purpose To determine the extent of implementation of the three … was issued on Report April 26, 2013, our objective was to determine whether the New York State Thruway Authority … To determine the extent of implementation of the three …
https://www.osc.ny.gov/state-agencies/audits/2014/06/25/inspecting-highway-bridges-and-repairing-defects-followMedicaid Claims Processing Activity October 1, 2008 Through March 31, 2009 (Follow-Up)
… were accurately processed, and resulted in correct provider payments. We identified five reportable conditions. The first reportable condition entailed the identification and … Other Related Audits/Reports of Interest Department of Health: Medicaid Claims Processing Activity October 1, 2008 …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/medicaid-claims-processing-activity-october-1-2008-through-march-31-2009-followRebates and Discounts on Physician-Administered Drugs (Follow-Up)
… in our initial audit report, Rebates and Discounts on Physician-Administered Drugs (2010-S-72). Background … qualified providers. Providers are required to pass on the savings to Medicaid when they submit claims for 340B drugs. Our initial audit report, which was issued on July 24, 2012, determined the Department of Health had …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/rebates-and-discounts-physician-administered-drugs-followOversight of Grants (Follow-Up)
… as of March 7, 2014 of the eight recommendations in our initial audit report, Oversight of Grants (2009-S-78). … Key Findings Department officials have made progress in correcting the problems identified in our initial report. Of the eight prior audit … as of March 7 2014 of the eight recommendations in our initial audit report Oversight of Grants …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/oversight-grants-followCollection of Medicaid Accounts Receivable (Follow-Up)
… Background Our initial audit report, which was issued on September 9, 2010, examined whether the Department of … and seek recovery of accounts receivable that were owed by providers when they joined a group practice. We also … 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/2013/09/05/collection-medicaid-accounts-receivable-followOversight of the STEM Incentive Program (Follow-Up)
… Objective To determine the extent of implementation of the four recommendations included in our initial audit … To determine the extent of implementation of the four recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2020/03/11/oversight-stem-incentive-program-followMedicaid Program – Medicaid Claims Processing Activity April 1, 2018 Through September 30, 2018
… to the providers. The audit covered the period April 1, 2018 through September 30, 2018. About the Program The … weekly cycles, which averaged over 5.9 million claims and $1.4 billion in payments to providers. Key Findings The audit … comprehensive third-party health insurance (TPHI); $6.1 million was paid for an inpatient claim that contained an …
https://www.osc.ny.gov/state-agencies/audits/2019/07/10/medicaid-program-medicaid-claims-processing-activity-april-1-2018-through-september-30-2018Inappropriate Payments Related to Procedure Modifiers (Follow-Up)
… related to the surgery, such as evaluation and management (E/M) services, are included in Medicaid’s payment for the … to the E/M service. We issued our initial audit report on April 17, 2018. The audit objective was to determine …
https://www.osc.ny.gov/state-agencies/audits/2019/07/31/inappropriate-payments-related-procedure-modifiers-followCongregate Meal Services for the Elderly (Follow-Up)
… included in our initial audit report, Congregate Meal Services for the Elderly (Report 2016-N-5 ). About the … included in our initial audit report Congregate Meal Services for the Elderly …
https://www.osc.ny.gov/state-agencies/audits/2019/11/19/congregate-meal-services-elderly-follow