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United HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… Purpose To determine whether Long Island Laparoscopic Surgery, PLLC waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from … To determine whether Long Island Laparoscopic Surgery PLLC waived Empire Plan …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-laparoscopic-surgeryExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Report 2009-S-64). Background Our initial … Medicaid recipients who also have health insurance through Medicare. During the four year audit period ended June 30, … more proactive culture that seeks to ensure that Medicaid is the payer of last resort for services provided to dual …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). … Determine extent of implementation of 3 recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… To determine whether UnitedHealthcare improperly paid for medical services designated with modifier code 59 that … The Empire Plan is the primary health benefits plan for NYSHIP. The State Department of Civil Service administers … (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59Monitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance
… and to prevent cemeteries from falling into disrepair or insolvency. When a not-for-profit cemetery is abandoned, … to take on its corporate duties, responsibility generally falls to the local municipality and can become a financial … of data reliability and the Mainframe’s usefulness as a risk assessment tool. Due to these data limitations, it is …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/monitoring-not-profit-cemeteries-fiscal-stability-and-adequate-facility-maintenanceAdministration of the Contract With the Postgraduate Center for Mental Health
… To determine whether the Office of Mental Health (OMH) is effectively administering its Supportive Housing Contract … through the end of our fieldwork. Background OMH’s mission is to promote the mental health and well-being of all New Yorkers. One of OMH’s major programs is known as “supportive housing,” which combines affordable …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-postgraduate-center-mental-healthAdministration of Contract C007373 With the Institute for Community Living
… Purpose To determine whether the Office of Mental Health (OMH) is effectively administering its contract with the Institute for Community Living (ICL) by ensuring that contracted … To determine whether the Office of Mental Health OMH is effectively administering its contract …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-c007373-institute-community-livingStarting Point Services for Children – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Starting Point Services for Children … documented, program related, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost Manual (Manual). The audit included all expenses claimed on Starting Point’s …
https://www.osc.ny.gov/state-agencies/audits/2015/12/11/starting-point-services-children-compliance-reimbursable-cost-manualImproper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … To determine the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… care needs. The New York State Controlled Substances Act (Act) was enacted to combat the illegal use of controlled … six audit recommendations, five were implemented and one was partially implemented. Key Recommendation Officials …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followAstor Services for Children & Families – Compliance With the Reimbursable Cost Manual
… reported by Astor Services for Children & Families (Astor) on its Consolidated Fiscal Report (CFR) were properly … rates set by SED. These reimbursement rates are based on financial information, including costs, that Astor reports to SED on its annual CFR. To be eligible for reimbursement, reported …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-compliance-reimbursable-cost-manualMilestone School for Child Development – Compliance With the Reimbursable Cost Manual
… whether the costs reported by the Milestone School for Child Development (Milestone) on its Consolidated Fiscal … The audit included all expenses claimed on Milestone’s CFR for the fiscal year 2012-13, and certain expenses claimed on Milestone’s CFRs for the two fiscal years ended June 30, 2012. Background The …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualCity of Batavia – Awarding Contracts for Goods and Services (2013M-296)
… governed by a City Charter, general laws of the State of New York, and local laws and ordinances. The City has an … million. Key Findings The City did not properly award all contracts and has not annually reviewed the procurement … policy, as required, and update as needed. Execute all contracts in accordance with the Charter. Periodically …
https://www.osc.ny.gov/local-government/audits/city/2014/01/24/city-batavia-awarding-contracts-goods-and-services-2013m-296United HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
To determine whether Long Island Spine Specialists PC waived Empire Plan members outofpocket costs and if so to quantify the overpayments made by United
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-spine-specialistsWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported on the Consolidated Fiscal Reports (CFRs) of the Whitestone School for Child Development (Whitestone) … To determine whether the costs reported on the Consolidated Fiscal Reports of the Whitestone School for Child Development were …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… is transferred among different hospitals, two separate payments are made: a payment for the first hospital’s claim and a payment for the second hospital’s … between them. Inform providers how to properly bill for patient transfers among divisions of merged or consolidated …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilitiesBrighter Choice Charter Middle School for Girls – Financial Operations (2014M-301)
… of Trustees. Operating expenditures for the 2013-14 fiscal year totaled approximately $3.2 million. Key Findings The …
https://www.osc.ny.gov/local-government/audits/charter-school/2015/03/06/brighter-choice-charter-middle-school-girls-financial-operations-2014m-301Medicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… research and analytics, managed care rate setting, and drug rebate collections. On September 14, 2015, the … Interest Department of Health: Medicaid Program - Medicaid Drug Rebate Program Under Managed Care (2014-S-41) …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemDiNapoli: As State Tax Check-Off Options Increase, Spending Lags for Most
… which received 24.9% of the total, followed by Breast Cancer Research and Education (8.9%) and Food Banks (7.9%). … showed disbursements. Of these, only the funds for Breast Cancer Research and Education and Alzheimer's Disease Support …
https://www.osc.ny.gov/press/releases/2024/01/dinapoli-state-tax-check-off-options-increase-spending-lags-mostDiNapoli: Tax Exemptions Jump While Job Gains Slow for IDA Projects
… New York’s Industrial Development Agencies (IDAs) provided … of Port Jervis and Rensselaer to $13.6 million for the New York City IDA. DiNapoli has also renewed his call for … a copy of the report, visit: Annual Performance Report on New York State's Industrial Development Agencies - Fiscal …
https://www.osc.ny.gov/press/releases/2015/05/dinapoli-tax-exemptions-jump-while-job-gains-slow-ida-projects