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RFP#0010 – Financial Organization (Trustee) Services for Length of Service Award Programs
… through the following links: Request for Proposals , in PDF Attachment F , in PDF Forms Only , in MS Word format Responses to Questions Amendment #1 , Issued May …
https://www.osc.ny.gov/procurement/rfp0010Administration of the CityFHEPS Program for Department of Homeless Services Shelter Residents
… DSS has not provided adequate oversight of Subchapter B contractors, who are paid to manage apartments for CityFHEPS … and habitability standards, and that rental payments to contractors for units that become vacant are appropriate. For …
https://www.osc.ny.gov/state-agencies/audits/2024/10/30/administration-cityfheps-program-department-homeless-services-shelter-residentsAdministration of the CityFHEPS Program for Department of Social Services Homebase Clients
… To determine whether the New York City Department of Social Services (DSS) is administering the City Fighting … others. In October 2018, the New York City Department of Social Services (DSS) launched the City Fighting Homelessness … City Human Resources Administration (HRA), the largest social services agency in the country, and the New York City …
https://www.osc.ny.gov/state-agencies/audits/2026/01/07/administration-cityfheps-program-department-social-services-homebase-clientsMedicaid Program – Medicaid Payments for Early Refills of Prescription Drugs and Supplies
… has been used, or up to a 10-day supply of medication is remaining of the cumulative amount that has been dispensed …
https://www.osc.ny.gov/state-agencies/audits/2026/03/20/medicaid-program-medicaid-payments-early-refills-prescription-drugs-and-suppliesUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… our audit report, UnitedHealthcare: Improper Payments for Medical Services Designated By Modifier Code 59 (Report … with UnitedHealthcare (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s payments to medical providers are based, in part, on procedure codes …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… through New York State of Health (NYSOH), New York’s online health insurance marketplace, and the remainder were … Care Model Contract, when the Medicaid managed care provider and the comprehensive TPHI provider are the same, the State can disenroll the recipients …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… overpaid for out-of-network anesthesia services provided at Ambulatory Surgery Centers that were contractually … health care providers who agree to accept payments, at rates established by United, to furnish medical/surgical … all anesthesia services provided to Empire Plan members at their facilities to be performed by in-network providers. …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatorySchool for Language and Communication Development – Compliance With the Reimbursable Cost Manual
… (SED) guidelines, including the Reimbursable Cost Manual (RCM). The audit covered the expenses reported on … Services, Inc.: Compliance With the Reimbursable Cost Manual ( 2016-S-74 ) Kennedy Child Study Center: Compliance With the Reimbursable Cost Manual ( 2017-S-7 ) …
https://www.osc.ny.gov/state-agencies/audits/2018/04/16/school-language-and-communication-development-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… the costs were unnecessary and duplicative; $240,673 in lease expenses that were not in compliance with the Manual, …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualLifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… costs reported by Lifeline Center for Child Development, Inc. (Lifeline) on its Consolidated Fiscal Reports (CFRs) … Reimbursable Cost Manual (2015-S-67) Books and Rattles, Inc.: Compliance With the Reimbursable Cost Manual (2016-S-25) … costs reported by Lifeline Center for Child Development Inc on its Consolidated Fiscal Reports were reasonable …
https://www.osc.ny.gov/state-agencies/audits/2017/10/12/lifeline-center-child-development-inc-compliance-reimbursable-cost-manualUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… the rates participating providers agree to accept for the same services. Consequently, to encourage members to use less … Overpayments for Services at the Capital Region Ambulatory Surgery Center (2007-S-72) New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… Purpose To determine whether the Department of Health paid pharmacy providers for controlled substances in compliance with the New York … supply. During the audit period, the Medicaid program paid pharmacy providers through the fee-for-service method and the … To determine whether the Department of Health paid pharmacy providers for controlled substances in compliance …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… Purpose To determine whether Eastern Orange Ambulatory Surgery Center, LLC waived Empire Plan members’ out-of-pocket … on claims submitted to United by Eastern Orange Ambulatory Surgery Center, LLC (Eastern Orange), a non-participating … Overpayments for Services at the Capital Region Ambulatory Surgery Center (2007-S-72) New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial … 2011, Medicaid made improper payments totaling $94,460 to Davis Ethical Pharmacy. Based on information obtained from … indicated on the claims), auditors determined that Davis Ethical likely fabricated nearly all of the improper …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… Purpose To determine whether Medicaid made improper fee-for-service claim payments for … October 1, 2011 through December 31, 2013. Background Medicaid provides a wide range of medical services to those … and/or have special health care needs. In general, the Medicaid program pays medical providers through either the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careEducators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)
… submitted periodic expenditure reports to SED and OCFS. We reviewed claims amounting to $1.8 million, out of $3.2 million in contract payments, to determine if the claims were properly supported and appropriate. These … four administered by SED and three administered by OCFS. We found that Educators could not support or justify $883,530 …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/educators-children-youth-and-families-inc-use-contract-funds-followMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… for review. Medicaid reimbursement rates for inpatient hospital claims include the costs of most medical care provided during a hospital admission. As such, claims for ancillary services provided during a hospital admission are generally not reimbursable. In 2007, …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientOversight of Hotels and Motels Used for Homeless and Mixed-Use Temporary Residency
… Purpose To determine if the Office of Temporary and Disability Assistance (OTDA) and the Department of Health (DOH) are adequately ensuring that hotels and … 16, 2016. Background According to a 2016 Department of Housing and Urban Development report, of the more than …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-hotels-and-motels-used-homeless-and-mixed-use-temporary-residencySt. Mary’s Hospital for Children, Inc. – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by St Marys Hospital for Children Inc on its Consolidated Fiscal …
https://www.osc.ny.gov/state-agencies/audits/2022/11/09/st-marys-hospital-children-inc-compliance-reimbursable-cost-manualHebrew Academy for Special Children, Inc. – Compliance With the Reimbursable Cost Manual
… preschool Special Education Itinerant Teacher (SEIT), full- and half-day Special Class (SC), and full- and half-day Special Class in an Integrated Setting …
https://www.osc.ny.gov/state-agencies/audits/2020/02/04/hebrew-academy-special-children-inc-compliance-reimbursable-cost-manual