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Medicaid Claims Submitted by Accordis, Inc. on Behalf of the New York City Health and Hospitals Corporation
… submit Medicaid claims to the Department of Health’s eMedNY claims processing system for payment of their services. For various reasons, eMedNY denies payment of many claims. Claims that are denied can be … eMedNY. To accomplish this, Accordis determined the reason(s) for claim denials, reviewed pertinent patient medical …
https://www.osc.ny.gov/state-agencies/audits/2013/03/12/medicaid-claims-submitted-accordis-inc-behalf-new-york-city-health-and-hospitalsMedicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… overpayments occurred because the providers billed claims with incorrect Medicare Part C coinsurance, copayments, or … this report, to bill Medicare Part C claims in accordance with existing requirements to help ensure Medicaid claims are … Payments to Selected Providers for Services to Recipients with Medicare Part C Coverage (2010-S-22) …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsAssessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… expenses related to the administration of Sections 50(5) and 151 of the Workers’ Compensation Law. We performed our … and nonoccupational disabilities and sickness. Coverage for these benefits, with limited exception, is to be provided by their employers. The Board is also responsible for tracking its costs to administer the Workers’ …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Empire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… for hospital services according to contracts it negotiates with hospitals. The hospital contracts include reimbursement … eye – which cause vision problems. A cataract is corrected with surgery, which frequently involves removing the clouded lens and replacing it with an intraocular lens (such as a plastic lens). Empire …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsMedicaid Program – Improper Payments for Brand Name Drugs
… law directs pharmacies to substitute prescribed drugs with less expensive drugs containing the same active … this means a brand name drug will be substituted with a generic drug that is equivalent to the brand name … $1,011,990 in potential cost avoidance associated with 27,455 Medicaid FFS claims for drugs that appear to be …
https://www.osc.ny.gov/state-agencies/audits/2022/12/13/medicaid-program-improper-payments-brand-name-drugsMedicaid Program – Improper Medicaid Payments for Recipients in Hospice Care
… Purpose To determine whether Medicaid made improper payments to providers on behalf of recipients receiving hospice care. This audit … To determine whether Medicaid made improper payments to providers on behalf of recipients receiving hospice care …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-improper-medicaid-payments-recipients-hospice-careCVS Health – Temporary Holding Account Rebate Revenue
… Objective To determine if CVS Health remitted to the State Department of Civil Service … to eligible prescription drug claims maintained in CVS Health’s temporary holding account. Our audit covered the … nearly 1.1 million members. Civil Service contracted with CVS Health to administer the Empire Plan’s prescription drug …
https://www.osc.ny.gov/state-agencies/audits/2019/10/17/cvs-health-temporary-holding-account-rebate-revenueAccounts Payable Advisory No. 3
… System may have multiple Address Sequences associated with a Vendor ID. While some vendors have a single default … the system will populate the default address associated with the Vendor ID. Select the appropriate Address Sequence … in the system populating the default address associated with the Vendor ID. This could result in the payment being …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/3-address-sequenceAccounts Payable Advisory No. 28
… that authority by a rule or written directive filed with the Comptroller. Section 110 also requires the designee be identified in writing and filed with the Comptroller. Agencies are required to have proper … the Payment Process has been updated to provide agencies with an internal controls audit program to consider using for …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/28-internal-controls-certificationEndwell Fire District – Controls Over Financial Operations (2013M-277)
… are approximately $896,700, which are funded primarily with real property taxes. Key Findings The Board did not … that were approved by the Board and found discrepancies with 31 disbursements totaling $24,808. Of this amount, … The payroll vendor has access to a District bank account with a significant amount of District cash. While District …
https://www.osc.ny.gov/local-government/audits/fire-district/2014/01/31/endwell-fire-district-controls-over-financial-operations-2013m-277Rescue Fire Company, Inc. – Unaccounted-For Bar Receipts (2012M-250)
… fiscal year. Key Findings On August 21, 2012, we discussed with Company officials the deficiencies related to the bar … committee members routinely paid for bar-related purchases with undeposited cash generated from bar sales. We compared … by $41,359. After deducting $14,708 of purchases made with cash from bar sales and $2,897 in bar cash on hand as of …
https://www.osc.ny.gov/local-government/audits/fire-district/2013/04/19/rescue-fire-company-inc-unaccounted-bar-receipts-2012m-250Town of Rossie – Records and Reports and Cash Disbursements (2013M-168)
… The Town of Rossie is located in St. Lawrence County and has a population of 877. The Town Board comprises four elected members and a Town Supervisor. The Town’s 2012 budgeted operating … expenditures totaled $200,296 for the general fund and $288,160 for the highway fund. Key Findings The …
https://www.osc.ny.gov/local-government/audits/town/2013/10/04/town-rossie-records-and-reports-and-cash-disbursements-2013m-168Frontier Central School District – Financial Condition and Mobile Devices (2013M-297)
… employees did not use mobile devices in accordance with the District’s acceptable-use policy. For example, on 23 … Use the workers’ compensation reserve in accordance with statute. Develop and implement a multiyear financial … and limiting administrative access. Monitor compliance with and enforce the District’s acceptable-use policy. …
https://www.osc.ny.gov/local-government/audits/school-district/2014/02/28/frontier-central-school-district-financial-condition-and-mobile-devicesVillage of Montgomery – Purchasing and Information Technology (2013M-210)
… to review internal controls over the Village’s purchasing and information technology (IT) operations for the period … is located in the Town of Montgomery in Orange County and has a population of about 3,800. The Village is governed … five-member elected Board of Trustees comprising the Mayor and four Trustees. The Village’s total general fund …
https://www.osc.ny.gov/local-government/audits/village/2013/10/25/village-montgomery-purchasing-and-information-technology-2013m-210Town of Huntington – Payroll and Legal Services (2013M-28)
… by contract bargaining agreements. The Town contracted with 23 attorneys, who were paid a total of $1.9 million … policy. Further, although the Town had written agreements with these attorneys, the agreements did not require that … agreements and limit leave accrual balances in accordance with these agreements. Consider using a RFP process to …
https://www.osc.ny.gov/local-government/audits/town/2013/05/24/town-huntington-payroll-and-legal-services-2013m-28Village of Greenwich – Justice Court Operations (2014M-023)
… Justice has not properly reviewed the former Justice’s pending cases. Key Recommendations Prepare monthly bank … to the JCF in a timely manner. Monitor and review all pending cases and close them, as applicable. …
https://www.osc.ny.gov/local-government/audits/justice-court/2014/05/30/village-greenwich-justice-court-operations-2014m-023Town of Bangor – Board Oversight (2012M-193)
… fiscal year are approximately $981,500, funded primarily with real property taxes. Key Findings The Board is not … and disbursements for their respective operations with no Board oversight. The Board’s review of claims was … to Town officers and employees that are in compliance with laws and regulations. Town officers and employees should …
https://www.osc.ny.gov/local-government/audits/town/2013/02/01/town-bangor-board-oversight-2012m-193Starpoint Central School District – Audit Follow-Up (2022M-101-F)
… Central School District’s (District’s) progress, as of May 2025, in implementing our recommendations in the audit report … Central School Districts Districts progress as of May 2025 in implementing our recommendations in the audit report …
https://www.osc.ny.gov/local-government/audits/school-district/2025/09/05/starpoint-central-school-district-audit-follow-2022m-101-fWarsaw Fire Department – Internal Controls Over Financial Operations (2013M-347)
… to residents outside the Village pursuant to contracts with the Towns of Orangeville, Warsaw and Middlebury. The Company is operated in accordance with its by-laws which stipulate that an elected Board of … because the Treasurer does not provide the Board with monthly or annual reports. The Treasurer does not …
https://www.osc.ny.gov/local-government/audits/fire-company-or-department/2014/01/31/warsaw-fire-department-internal-controls-over-financialDiNapoli: State Pension Fund Investments Return 11.55% for State Fiscal Year 2023-24
… year that ended March 31, 2024. The Fund closed the year with an estimated value of $267.7 billion. “Strong … fund’s investment returns higher over the past year, with many companies reporting better than expected earnings … by investment results over a multi-year period along with numerous other actuarial assumptions, including wage …
https://www.osc.ny.gov/press/releases/2024/06/dinapoli-state-pension-fund-investments-return-1155-state-fiscal-year-2023-24