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Status of the Board-Approved Capital Plan for 2005-2011 (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations included in our initial report, … To determine the extent of implementation of the five recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2013/06/27/status-board-approved-capital-plan-2005-2011-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… implemented sufficient controls over the identification and recovery of overpayments made to hospitals for special medical items; and took sufficient steps to minimize the State’s risk of … health insurance coverage to about 1.2 million active and retired State, participating local government, and school …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsManagement of Indoor Air Quality for Individuals With Asthma
… hospitalizations due to asthma and limiting exposure to indoor air pollutants that are known asthma triggers. To … through its contracts with LHDs, has identified poor indoor environmental conditions that impact residents with …
https://www.osc.ny.gov/state-agencies/audits/2022/08/02/management-indoor-air-quality-individuals-asthmaImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… audit report, Improper Medicaid Payments for Recipients in Hospice Care ( 2017-S-76 ). About the Program Hospice is a program that provides care to terminally ill … Generally, when eligible Medicaid recipients elect hospice care, they waive their right to use Medicaid for …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followMedicaid Program – Improper Medicaid Payments for Misclassified Patient Discharges
… to reimburse hospitals for inpatient medical care. When a hospital bills Medicaid for an inpatient stay, the hospital reports certain information on its claims, such as … information is used to calculate the payment made to the hospital. Hospitals must also use certain patient status …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesBenefits Advisement Services for Individuals With Disabilities Seeking Employment
… Objective To determine if the Office of Mental Health (OMH) has effectively addressed the findings and recommendation related to benefits advisement in the New York State Employment First Commission report. The … To determine if the Office of Mental Health OMH has effectively addressed the …
https://www.osc.ny.gov/state-agencies/audits/2021/07/20/benefits-advisement-services-individuals-disabilities-seeking-employmentUse of Federal Funding for Election Technology and Security
… from the 2018 Help America Vote Act Election Security Grant to enhance the security of the State’s election … systems. In 2018, the EAC made the HAVA Election Security Grant (HAVA Security Grant) available to help states improve and enhance election … from the 2018 Help America Vote Act Election Security Grant to enhance the security of the States election …
https://www.osc.ny.gov/state-agencies/audits/2021/09/17/use-federal-funding-election-technology-and-securityUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… using reasonable and customary (R&C) reimbursement rate schedules that did not correlate with the date of the service … claims using reasonable and customary reimbursement rate schedules that did not correlate …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… made in our initial audit report, Maximizing Drug Rebates for Health and Recovery Plans (Report … About the Program In 1990, Congress created the Medicaid Drug Rebate Program, which allows states to recover a portion of their Medicaid prescription drug costs by requesting rebates from drug manufacturers. The …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/maximizing-drug-rebates-health-and-recovery-plans-followEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… in our initial audit report, Controls Over Payments for Special Items (Report 2016-S-57 ). About the Program The … The Empire Plan is the primary health benefits plan for NYSHIP. Empire BlueCross (Empire) administers the … portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… 2021 for non-oxygen-related durable medical equipment rentals and September 2018 to December 2021 for oxygen-related durable medical equipment rentals. About the Program The Department of Health … allowed. By comparison, under Medicare, oxygen equipment rentals are subject to a 36-month limit. Key Findings We …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsSelected Aspects of Accommodations for Passengers With Disabilities (Follow-Up)
… requirement. The Rehabilitation Act of 1973 requires airport (and terminal) operators to be responsible for … sector, PANYNJ did not have written agreements between the airport operator and terminal operator allocating … for meeting the boarding requirements with all airport operators and carriers, as required by federal …
https://www.osc.ny.gov/state-agencies/audits/2023/05/12/selected-aspects-accommodations-passengers-disabilities-followImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
To assess the extent of implementation of the five recommendations included in our initial audit report Improper Managed Care Payments for Misclassified Patient Discharges
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followAnnual Assessment of Market Orders for 2015 and 2016
… 2014 through June 30, 2016 for the Apple and Sour Cherry Market Orders and the period April 1, 2014 through March 31, … the Program During the audit period, the Department’s Market Order Administration was responsible for the administration of all farm product market orders, except those involving dairy products. Each …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/annual-assessment-market-orders-2015-and-2016Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services
… Hospitals use International Classification of Diseases (ICD) procedure codes on their claims to report mechanical … ventilation services. When hospitals use a specific ICD procedure code to report a patient received 96 … for 4,874 inpatient APR-DRG claims that included an ICD procedure code for 96 consecutive hours or more of …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-servicesMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… services that are not covered by original Medicare (e.g., dental services). Plans reimburse health care providers for …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… in our initial audit report Restrictions on Consecutive Hours of Work for Nurses (Report 2017-S-14 ). About the … Labor Law – referred to as the Restrictions on Consecutive Hours of Work for Nurses Law (Law). Effective July 2009, the Law limits the consecutive hours of work by Registered Nurses (RNs) and Licensed …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-followImplementation of the Dignity for All Students Act (Follow-Up)
… the Program New York State’s Dignity for All Students Act (DASA) seeks to provide students in New York with a safe and … school property, on school buses, and at school functions. DASA’s initial provisions, which took effect July 1, 2012, … guidance to assist school districts in complying with DASA requirements. For the school year ended June 30, 2018, …
https://www.osc.ny.gov/state-agencies/audits/2019/11/21/implementation-dignity-all-students-act-followMedicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… audit covered the period from December 2020 through May 2024. About the Program The Department of Health (DOH) … with third-party insurers prior to billing Medicaid for services. After processing a claim from a provider, the … (ERA) statement to the provider, explaining the reason for any adjustments made to the claim amount. Claim …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsTown of Somerset – Budgeting for Sales Tax (2016M-419)
… 1, 2015 through November 18, 2016. Background The Town of Somerset is located in Niagara County and has a population of … Town of Somerset Budgeting for Sales Tax 2016M419 …
https://www.osc.ny.gov/local-government/audits/town/2017/11/22/town-somerset-budgeting-sales-tax-2016m-419