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Medicaid Program – Errors in Identification of 340B Providers in the Medicaid Drug Rebate Program
… discount the price of drugs sold to eligible health care providers. The Medicaid program benefits when these providers submit claims reflecting the discounted (lower) … rebate process. Accordingly, the Department has instructed providers to accurately identify 340B drugs with the required …
https://www.osc.ny.gov/state-agencies/audits/2017/06/30/medicaid-program-errors-identification-340b-providers-medicaid-drug-rebate-programElmcrest Children’s Center, Inc. – Compliance With the Reimbursable Cost Manual
… whether the costs reported by Elmcrest Children’s Center, Inc. (Elmcrest) on its Consolidated Fiscal Report … integrated preschool classroom within its early education center. Elmcrest is authorized by SED to provide preschool … Compliance With the Reimbursable Cost Manual (2015-S-45) Center for Disability Services: Compliance With the …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/elmcrest-childrens-center-inc-compliance-reimbursable-cost-manualControls Over Revocable Consents (Follow-Up)
To determine the extent of implementation of the five recommendations in our initial audit report Controls Over Revocable Consents Report 2018N1
https://www.osc.ny.gov/state-agencies/audits/2022/05/13/controls-over-revocable-consents-followMedicaid Program – Oversight of Managed Long-Term Care Member Eligibility
… Objective To determine whether the Department of Health (Department) … enrollees. The audit covered the period from January 2015 to March 2021. About the Program Many of the State’s Medicaid … contracts with Maximus Health Services, Inc. (Maximus) to conduct initial eligibility assessments for individuals …
https://www.osc.ny.gov/state-agencies/audits/2022/08/05/medicaid-program-oversight-managed-long-term-care-member-eligibilityReporting of Community-Based Services Under the Transformation Reinvestment Plan
… teams, various crisis services, and clinic expansion. One key piece of data on the monthly reports is known as “New …
https://www.osc.ny.gov/state-agencies/audits/2022/10/26/reporting-community-based-services-under-transformation-reinvestment-planAuditory Oral Learning Center – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by the Auditory Oral … Report (CFR) were reasonable, necessary, directly related to the special education program, and sufficiently documented, pursuant to the State Education Department’s (SED) Reimbursable Cost …
https://www.osc.ny.gov/state-agencies/audits/2019/12/31/auditory-oral-learning-center-compliance-reimbursable-cost-manualQuality Services for the Autism Community – Compliance With the Reimbursable Cost Manual
… consisted of $2,075 for depreciation charged to SC and $624 for administration depreciation expenses. QSAC did not …
https://www.osc.ny.gov/state-agencies/audits/2019/12/31/quality-services-autism-community-compliance-reimbursable-cost-manualMinds in Motion, Inc. – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Minds in Motion, … MIM provides preschool special education services to children with disabilities who are between three and four … financial information, including costs, that MIM reports to SED on its annual CFR. To be eligible for reimbursement, …
https://www.osc.ny.gov/state-agencies/audits/2019/12/31/minds-motion-inc-compliance-reimbursable-cost-manualSafety at Stations (Follow-Up)
… Department of Subways. SIR operates a single rapid transit line, which runs the length of Staten Island (about 14 miles) … The process of responding to an incident starts when the Rail Control Center receives the call, prepares an Exception …
https://www.osc.ny.gov/state-agencies/audits/2020/01/06/safety-stations-followControls Over Equipment (Follow-Up)
To assess the extent of implementation of the six recommendations included in our initial audit report Controls Over Equipment Report 2017N9
https://www.osc.ny.gov/state-agencies/audits/2022/12/20/controls-over-equipment-followCase Management
… Objective To determine whether the New York City Department for the Aging provided and paid case … and comfortably in one’s home for as long as possible. The New York City (City) Department for the Aging (DFTA) is the … To determine whether the New York City Department for the Aging provided and paid case …
https://www.osc.ny.gov/state-agencies/audits/2023/07/26/case-managementMedicaid Program – Improper Medicaid Payments During Permissible Overlapping Medicaid and Essential Plan Coverage
… New York’s Medicaid program, which provides health care services to individuals who are economically … Essential Plan coverage, the Essential Plan should be the primary payer and Medicaid, as secondary payer, should pay … been improperly paying the full amount for services as the primary payer since inception of the Essential Plan. Our …
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-improper-medicaid-payments-during-permissible-overlapping-medicaid-andSelected Wage Investigation Procedures (Follow-Up)
… deductions, day-of-rest and meal period requirements, and child labor. Division investigators from 12 District Offices … wages. During that audit, we found that, for 69 of the 150 cases in our sample (46%), investigators did not make first … docketing), as recommended in DOL procedures. The 69 cases included 13 cases for which more than 360 days passed …
https://www.osc.ny.gov/state-agencies/audits/2024/02/16/selected-wage-investigation-procedures-followWelcome Center and Rest Area Planning and Implementation
… services. The Rest Area Plan supports providing Welcome Centers located within 20 minutes of key entry points to the … are more than 20 years old, and 2 recently opened Welcome Centers. During our audit scope, the Department managed 52 … related to Rest Areas and 21 projects related to Welcome Centers totaling about $333 million. Subsequent to our audit …
https://www.osc.ny.gov/state-agencies/audits/2019/06/20/welcome-center-and-rest-area-planning-and-implementationChildren’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Children’s Unit for Treatment and … calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the Reimbursable Cost Manual (RCM). The audit covered … To determine whether the costs reported by Childrens Unit for Treatment and …
https://www.osc.ny.gov/state-agencies/audits/2019/07/15/childrens-unit-treatment-and-evaluation-compliance-reimbursable-cost-manualDepartment of Labor Examination of Unemployment Insurance Benefit Payments January 1, 2017 – December 31, 2017
… were to determine whether: (i) Unemployment Insurance (UI) benefit payments approved by the Department of Labor … As part of our Office’s audit of the Department’s UI program, we examined high risk payment requests approved … entitled. We also worked with DOL to offset $204,464 in UI benefit payments against penalties assessed for …
https://www.osc.ny.gov/state-agencies/audits/2018/11/19/department-labor-examination-unemployment-insurance-benefit-payments-january-1-2017Medicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… typically covered by a recipient’s Plan. We sampled 266 such claims (totaling $220,661 in Medicaid payments) to … Among our findings: For 187 claims (70 percent of the 266 claims), the provider either never billed the Plan for …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesFood Metrics Implementation (Follow-Up)
… Purpose To determine the extent of implementation of the two … Food Metrics Implementation ( 2017-S-18 ). Background To assist agencies in increasing their New York State food … (OGS) and the Department of Agriculture and Markets to develop regulations, establish guidelines, and provide …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/food-metrics-implementation-followContinuity of Operations Planning (Follow-Up)
… Objective To determine the extent of implementation of the two … The Division encourages and supports State agency efforts to develop agency-specific Continuity of Operations Plans … a series of guidance documents (Guidance) intended to aid agency planning teams when they prepare COOPs. The …
https://www.osc.ny.gov/state-agencies/audits/2019/09/11/continuity-operations-planning-followMedicaid Program – Claims Processing Activity October 1, 2018 Through March 31, 2019
… were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit covered the … was paid for practitioner, pharmacy, inpatient, lab, and clinic claims that did not comply with Medicaid policies; …
https://www.osc.ny.gov/state-agencies/audits/2019/09/27/medicaid-program-claims-processing-activity-october-1-2018-through-march-31-2019