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Medicaid Program – Medicaid Payments to Medicare Advantage Plan Providers
… through Medicare Advantage plans, which have networks of participating providers that they reimburse for services … Medicaid reimburses the plan providers for the enrollee’s Part C cost-sharing liabilities (deductibles, coinsurance, … were overpaid 58, 74, and 79 percent of the total Medicaid payments they received for claims in our review. We analyzed …
https://www.osc.ny.gov/state-agencies/audits/2018/09/10/medicaid-program-medicaid-payments-medicare-advantage-plan-providersDrug and Alcohol Treatment Program – Provider Claiming of Depreciation Expenses (Follow-Up)
… included in our initial audit report, Drug and Alcohol Treatment Program: Provider Claiming of Depreciation … that strengthen communities, schools, and families through alcohol and drug prevention and treatment and to meet … into agreements with providers for delivery of specific alcohol- and drug-related services. OASAS reimburses the …
https://www.osc.ny.gov/state-agencies/audits/2018/09/05/drug-and-alcohol-treatment-program-provider-claiming-depreciation-expenses-followSecurity Over Electronic Protected Health Information (Follow-Up)
… of implementation of the four recommendations included in our initial audit report, Security Over Electronic … Portability and Accountability Act security requirements. In addition, the Institute had adequate protection policies in place and a plan to make mandatory notifications when ePHI …
https://www.osc.ny.gov/state-agencies/audits/2016/10/07/security-over-electronic-protected-health-information-followMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… initial audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background … which was issued on December 9, 2010, examined whether 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. …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followWage Theft Investigations (Follow-Up)
… in addressing the issues identified in our initial report. For example: The Department is now completing 80 percent of … follow up, the Division only had 305 cases that were open for more than one year. This was accomplished primarily by … its upstate districts conduct mail/phone investigations for the New York City area, where the majority of these …
https://www.osc.ny.gov/state-agencies/audits/2015/05/22/wage-theft-investigations-followAudit of the Tuition Assistance Program at New York Career Institute
… students for State-funded Tuition Assistance Program (TAP) awards. Background New York Career Institute (NYCI) is a … serves approximately 600 students and tuition is about $4,250 per trimester ($12,750 per year). TAP is an entitlement … the Tuition Assistance Program at Mercy College (2012-T-3) …
https://www.osc.ny.gov/state-agencies/audits/2014/02/07/audit-tuition-assistance-program-new-york-career-instituteViolations of Law, Conflicts of Interest and Other Improprieties at the Department of Correctional Services' Food Production Center (Follow-Up)
… the Department of Correctional Services' Food Production Center (2009-S-6). Background On August 31, 2010, we reported the results of our audit of certain Center procurement contracts and payments to vendors for … 31, 2009. Our objective was to determine whether former Center Director Howard Dean, his staff, and various food …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/violations-law-conflicts-interest-and-other-improprieties-department-correctional-servicesControls Over Cash Advance Accounts
… Compensation Board (WCB) has adequate controls over the cash advance accounts it oversees to ensure the money is … advances are issued to State agencies for purposes such as petty cash, travel, and other funding needs (e.g., subpoena … and found that both checks never cleared. Although the petty cash account is needed for subpoena fees, a New York …
https://www.osc.ny.gov/state-agencies/audits/2014/06/25/controls-over-cash-advance-accountsUniversity at Buffalo – Selected Employee Travel Expenses
… monies by selected government employees complied with rules and regulations and is free from fraud, waste and abuse. The … for audit were documented and adhered to State travel rules and regulations. The 13 employees are athletic coaches … monies by selected government employees complied with rules and regulations and is free from fraud waste and abuse …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/university-buffalo-selected-employee-travel-expensesThe Child Development Council, Inc. – Compliance With the Reimbursable Cost Manual
… The non-reimbursable costs included $5,394 in ineligible property expenses, $3,609 in ineligible food costs, $2,337 in …
https://www.osc.ny.gov/state-agencies/audits/2016/11/17/child-development-council-inc-compliance-reimbursable-cost-manualCVS Health - Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations included in our initial audit … To determine the extent of implementation of the five recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2020/12/29/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… Objective To determine the extent of implementation of the six recommendations included in our initial audit … To determine the extent of implementation of the six recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2021/02/08/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followUse of Federal Funding for Election Technology and Security
… available funding from the 2018 Help America Vote Act Election Security Grant to enhance the security of the State’s election technology and infrastructure. The audit covered the … available funding from the 2018 Help America Vote Act Election Security Grant to enhance the security of the States …
https://www.osc.ny.gov/state-agencies/audits/2021/09/17/use-federal-funding-election-technology-and-securityUnitedHealthcare – 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-claimsAdministration of the Contract With the Postgraduate Center for Mental Health (Follow-Up)
… Objective To determine the extent of implementation of the nine recommendations included in our initial audit … of the Contract With the Postgraduate Center for Mental Health ( 2015-S-88 ). About the Program Our initial report, … To determine the extent of implementation of the nine recommendations …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/administration-contract-postgraduate-center-mental-health-followImproper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (Follow-Up)
… the appropriate International Classification of Diseases (ICD) code on its Medicaid claim to reflect the diagnosis. …
https://www.osc.ny.gov/state-agencies/audits/2020/09/02/improper-medicaid-payments-recipients-diagnosed-severe-malnutrition-followChildren’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual
… with disabilities who are between three and five years of age. CUTE is reimbursed for these services through rates … million in reimbursable costs for the Preschool Special Class that it provided. Key Findings For the three fiscal … CUTE’s tuition reimbursement rates. Remind CUTE officials of the pertinent SED requirements that relate to the …
https://www.osc.ny.gov/state-agencies/audits/2019/07/15/childrens-unit-treatment-and-evaluation-compliance-reimbursable-cost-manualMonitoring of Prevailing Wage Compliance on Construction Contracts (Follow-Up)
… was partially implemented. Key Recommendation Officials are given 30 days after the issuance of the follow-up report to provide information on any actions that are planned to address the unresolved issues discussed in …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/monitoring-prevailing-wage-compliance-construction-contracts-followOversight of Resident Care-Related Medical Equipment in Nursing Homes (Follow-Up)
… of Resident Care-Related Medical Equipment in Nursing Homes (Report 2016-S-80 ). About the Program The … Health’s (Department) monitoring and inspection of nursing homes is sufficient to determine if nursing homes perform comprehensive inspections, testing, and …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/oversight-resident-care-related-medical-equipment-nursing-homes-followOversight of Young Adult Institute, Inc.'s Family Support Services Contracts (Follow-Up)
… audit report, Oversight of Young Adult Institute, Inc.’s Family Support Services Contracts (Report 2017-S-29 ). … than 140,000 New Yorkers with developmental disabilities. Family Support Services (FSS) are designed to help families … audit report Oversight of Young Adult Institute Incs Family …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/oversight-young-adult-institute-incs-family-support-services-contracts-follow