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Medicaid Program – Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition
… malnutrition diagnosis . The audit covered the period from January 1, 2013 through December 31, 2017. Background Malnutrition can result from the general deterioration of an individual’s health, inadequate treatment or neglect, or from the treatment of another condition. Once malnutrition is …
https://www.osc.ny.gov/state-agencies/audits/2019/04/08/medicaid-program-improper-medicaid-payments-recipients-diagnosed-severe-malnutritionMedicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… recipients in need of inpatient hospital care are provided a full range of necessary diagnostic, palliative and … Medicaid for inpatient services, hospitals must indicate a patient's level of care on a claim to ensure accurate … correctly (with 248 days at the ALC rate), Medicaid would have paid only $67,748. Thus, Medicaid overpaid the hospital …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissionsMay 1998: Accounting Requirements and Program Information for Multi-Modal Transportation Program
… Issued To: New York State Chief Fiscal Officers of Counties, Cities, Towns and Villages Accounting … will be classified by functional unit based on the type of project being undertaken. Enterprise funds should … provided by the State Legislature and by the Department of Transportation: Background - In Chapters 637 and 638 of …
https://www.osc.ny.gov/local-government/publications/may-1998-accounting-requirements-and-program-information-multi-modal-transportation-programInterdisciplinary Center for Child Development – Compliance With the Reimbursable Cost Manual
… to children with disabilities who are between the ages of three and five years. During the 2014-15 school year, ICCD … in Queens and Nassau County. The New York City Department of Education (DoE) and local school districts refer students … Compliance With the Reimbursable Cost Manual ( 2016-S-95 ) Kennedy Child Study Center: Compliance With the Reimbursable …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/interdisciplinary-center-child-development-compliance-reimbursable-cost-manualUnited HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… 1, 2011 through March 31, 2015. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating local government, and school district … procedures and physician office visits. The New York State Department of Civil Service contracts with United …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-laparoscopic-surgeryUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… members. United’s payments to medical providers are based, in part, on procedure codes billed on claims that indicate … United will not pay for certain procedure codes billed in combination with other procedure codes unless the provider … for claims preparation and submission. Recover the $39,345 in overpayments identified by our audit. As priorities and …
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
… State. As authorized by Article 15 of the Not-for-Profit Corporation Law (Law), and under the supervision of the …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/monitoring-not-profit-cemeteries-fiscal-stability-and-adequate-facility-maintenanceMilestone 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)
… of our audit was to review the City’s purchasing process for the period April 1, 2012 through September 6, 2013. … or indicate the selection basis, such as using requests for proposals (RFPs), when procuring professional services. … four vendors totaled $260,987 during our audit period for: legal services ($131,257), insurance ($73,699), …
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
… The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … process and pay medical claims from health care providers for services provided to Empire Plan members. United … pay a nominal co-payment to the participating provider for the services rendered. Members may also choose to receive …
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
… Fiscal Reports (CFRs) of the Whitestone School for Child Development (Whitestone) were calculated properly, … Manual (Manual). The audit included all expenses claimed for the fiscal year 2012-13 and certain expenses for the two fiscal years ended June 30, 2012. Background …
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
… Health established adequate controls over inpatient claims for recipients who were transferred between merged or … responsibilities include establishing Medicaid policies for reimbursing hospitals and other health care providers for their services. Generally, when a Medicaid recipient is …
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)
… the effectiveness of the School’s contract with a not-for-profit foundation for the period July 1, 2011 through June 30, 2014. Background The Brighter Choice Charter Middle School for Girls is a public school that is not under the control of …
https://www.osc.ny.gov/local-government/audits/charter-school/2015/03/06/brighter-choice-charter-middle-school-girls-financial-operations-2014m-301DiNapoli: School District Tax Levy Cap at 2% for Third Straight Year
… Property tax levy growth for school districts and 10 of the state’s cities will be … DiNapoli’s office calculated the inflation factor at 4.12% for those with a June 30, 2025 fiscal year end. “While … 2% allowable levy growth affects the tax cap calculations for 676 school districts and 10 cities with fiscal years …
https://www.osc.ny.gov/press/releases/2024/01/dinapoli-school-district-tax-levy-cap-2-third-straight-yearWestchester School for Special Children – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by the Westchester School for Special Children (WSSC) on its Consolidated Fiscal … June 30, 2011, WSSC claimed approximately $48.7 million in public support. Key Findings We disallowed $802,912 in …
https://www.osc.ny.gov/state-agencies/audits/2013/07/02/westchester-school-special-children-compliance-reimbursable-cost-manualCalculating the Maximum Amount Eligible for Amortization or the Graded Payment – Contribution Stabilization Program
… for deficiency, previous amortizations, incentive costs or prior years’ adjustments). Determines the employer’s … contribution from the employer’s normal contribution. OR Determines the Graded Payment Amount Subtracts the …
https://www.osc.ny.gov/retirement/employers/csp/calculating-maximum-amount-eligible-amortization-or-graded-paymentCharter School for Applied Technologies – Payment to Affiliated Entities (2013M-300)
… with its affiliated entities and any related payments for the period July 1, 2010 through January 11, 2013. … private entities which the Board caused to be established for the purpose of enabling the School to engage in what are … entity’s financial records. The School made payments for services to one of the entities without a written …
https://www.osc.ny.gov/local-government/audits/school-district/2014/01/17/charter-school-applied-technologies-payment-affiliated-entities-2013m-300Albany Leadership Charter High School for Girls – Professional Services (2013M-283)
… contract with the Brighter Choice Foundation (Foundation) for the period July 1, 2011 through May 31, 2013. Background The Albany Leadership Charter High School For Girls, located in the City of Albany, Albany County, is … voting members. The School’s budgeted operating expenses for the 2012-13 fiscal year totaled approximately $4.7 …
https://www.osc.ny.gov/local-government/audits/charter-school/2014/01/17/albany-leadership-charter-high-school-girls-professional-services-2013mEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital … schedules. Intraocular lenses are used in the treatment of cataracts – the clouding of the lens in the eye – which cause vision problems. A …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsMedicaid Program – Improper Payments of Medicare Buy-in Premiums for Ineligible Recipients
… Program The Department of Health (Department) administers New York’s Medicaid program. Many Medicaid recipients are also …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-payments-medicare-buy-premiums-ineligible-recipients