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United HealthCare Insurance Company of New York – Empire Plan Drug Rebates (Follow-Up)
… Purpose To determine the implementation status of the two recommendations made in our audit report, … To determine the implementation status of 2 recommendations made in our audit report United …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/united-healthcare-insurance-company-new-york-empire-plan-drug-rebates-followMedicaid Program – Medicaid Claims Processing Activity October 1, 2015 Through March 31, 2016
… Purpose To determine whether the Department of Health’s eMedNY system reasonably ensured that … October 1, 2015 through March 31, 2016. Background The Department of Health (Department) administers the State’s Medicaid program. The … To determine whether the Department of Healths eMedNY system reasonably ensured that …
https://www.osc.ny.gov/state-agencies/audits/2016/11/30/medicaid-program-medicaid-claims-processing-activity-october-1-2015-through-march-31-2016Facility Structure, Safety, and Health Code Waivers (Follow-Up)
… audit report, Facility Structure, Safety, and Health Code Waivers (Report 2014-S - 27). Background There are … in place at a given facility, nor could it identify the code violations that had been waived at those facilities. … of Health: Facility Structure, Safety, and Health Code Waivers ( 2014-S-27 ) …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/facility-structure-safety-and-health-code-waivers-followTrash Can Free Stations Pilot Program (Follow-Up)
… recommendations included in our initial report, Trash Can Free Stations Pilot Program (2014-S-29). Background Our … three recommendations included in our initial report Trash Can Free Stations Pilot Program 2014S29 …
https://www.osc.ny.gov/state-agencies/audits/2017/02/14/trash-can-free-stations-pilot-program-followAdministration of the Article 8-A Loan Program (Follow-Up)
… the requirements of their loans with respect to correcting violations and making other needed repairs. We found that HPD … in revenue. We also found that many significant building violations and agreed-upon repairs go unaddressed by owners, …
https://www.osc.ny.gov/state-agencies/audits/2017/04/12/administration-article-8-loan-program-followOversight of Homeless Shelters (Follow-Up)
… in the operation of these programs. Through its Bureau of Shelter Services, the Office seeks to meet critical … oversees these larger-scale facilities, and is responsible for inspecting these certified shelters and ensuring they … and Regulations. In contrast, it has delegated authority for oversight of smaller, uncertified shelters to the Local …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-homeless-shelters-followImproper Payments to a Physical Therapist (Follow-Up)
… in our initial audit report, Improper Payments to a Physical Therapist ( Report 2013-S-15 ). Background The … provides a wide range of health care services, including physical therapy services, to individuals who are … audit objectives were to determine whether Mark Amir, a physical therapist who owned and operated Madison Physical …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followOverpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Report 2013-S-57). Background The State’s … care. For example, MCOs receive a “Supplemental Low Birth Weight Newborn Capitation Payment” (low birth weight kick …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followExamination of Unemployment Insurance Willful Overpayments
… penalties in accordance with Federal and State law for unemployment insurance (UI) overpayments that resulted from claimants’ … benefits. Background UI benefits are temporary income for eligible workers who become unemployed through no fault … penalties in accordance with Federal and State law for unemployment insurance …
https://www.osc.ny.gov/state-agencies/audits/2018/09/25/examination-unemployment-insurance-willful-overpaymentsExamination of Travel Expenses
… official station will normally be the employee’s main place of business (i.e., the place where the employee … for the employee to commute between his residence and his main work location. Department officials informed us that on May 8, 2017, the employee’s assignment ended at his main work location. We confirmed the employee’s official …
https://www.osc.ny.gov/state-agencies/audits/2018/07/26/examination-travel-expensesMedicaid Claims Processing Activity October 1, 2011 Through March 31, 2012
… The audit covered the period October 1, 2011 through March 31, 2012. Background The Department of Health (Department) … for their claims. During the six-month period ended March 31, 2012, eMedNY processed approximately 233 million …
https://www.osc.ny.gov/state-agencies/audits/2013/07/09/medicaid-claims-processing-activity-october-1-2011-through-march-31-2012Medicaid Program – Medicaid Claims Processing Activity April 1, 2011 Through September 30, 2011
… Purpose To determine whether the Department of Health's eMedNY system reasonably ensured that … April 1, 2011 through September 30, 2011. Background The Department of Health (Department) administers the State's Medicaid program. The … To determine whether the Department of Healths eMedNY system reasonably ensured that …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-program-medicaid-claims-processing-activity-april-1-2011-through-september-30-2011Medicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
… Purpose To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … 2013 through September 30, 2013. Background The Department of Health (Department) administers the State’s Medicaid … 188 million claims, resulting in payments to providers of about $25 billion. The claims are processed and paid in …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013MTA-NYC Transit Medical Assessment Centers
… In addition, there is a 24-hour lab located in Downtown Brooklyn. Employees are assigned to a MAC according to their … location. If testing is needed, after regular business hours of 8 a.m. to 4 p.m., an employee, regardless of … or as little as $86.28 at a depot that paid for three hours at regular pay. We determined that employees were not …
https://www.osc.ny.gov/state-agencies/audits/2014/11/10/mta-nyc-transit-medical-assessment-centersCollection and Use of Oil Spill Funds
… are reasonable, appropriate, and associated with spill remediation projects. The audit covers the period April 1, … for providing technical assistance and oversight for spill remediation efforts and for ensuring that only allowable … Selected Aspects of Inactive Hazardous Waste Site Remediation Cost Recovery (2014-S-14) …
https://www.osc.ny.gov/state-agencies/audits/2015/08/13/collection-and-use-oil-spill-fundsMedicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
… claims for which eMedNY did not properly factor Medicare coverage or a lower level of care into the payment; $682,022 … with incorrect information pertaining to other health insurance coverage that recipients had; $112,981 in overpayments for nursing home claims for which eMedNY did not correctly deduct the …
https://www.osc.ny.gov/state-agencies/audits/2015/05/21/medicaid-program-medicaid-claims-processing-activity-october-1-2013-through-march-31-2014Housing Preferences for Disabled Veterans (Follow-Up)
… report, Housing Preference for Disabled Veterans (2010-S-42). Background In November 2007, the Private Housing Law was … Services: Housing Preference for Disabled Veterans (2010-S-42) …
https://www.osc.ny.gov/state-agencies/audits/2013/02/19/housing-preferences-disabled-veterans-followMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… Substances Act (Act), which was enacted to combat illegal use of controlled substances, limits the quantities of … a pharmacy filled two telephone orders for alprazolam (a drug used to treat anxiety) on the same day for one … for a 30-day supply even though telephone orders for this drug are limited to a five-day supply that can only be …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsQuality of Internal Control Certifications (Follow-Up)
… Purpose In 2012, we conducted a series of audits at 12 State agencies … to determine the degree of implementation by each agency in submitting their 2013-14 Internal Control Certifications … of the seven common recommendations included in our series of reports. Background Our initial audit …
https://www.osc.ny.gov/state-agencies/audits/2015/07/07/quality-internal-control-certifications-followWage Theft Investigations (Follow-Up)
… the Department had a caseload of 17,191 cases, including 9,331 active investigations and 7,860 cases pending payment. … 12,938 cases (75 percent) had been open more than one year since the initial claim was received. We also determined the … 80 percent of its wage investigations within six months. At the time of this follow up, the Division only had …
https://www.osc.ny.gov/state-agencies/audits/2015/05/22/wage-theft-investigations-follow