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Inappropriate Payments Related to Procedure Modifiers (Follow-Up)
… program, which provides a wide range of health care services to individuals who are economically disadvantaged … policies, payment for a surgical procedure includes all services normally performed during the preoperative, … the Department incorrectly implemented claims processing system controls to prevent inappropriate payments for E/M …
https://www.osc.ny.gov/state-agencies/audits/2019/07/31/inappropriate-payments-related-procedure-modifiers-followNursing Home Surveillance (Follow-Up)
… included in our initial audit report, Nursing Home Surveillance ( 2015-S-26 ). Background The Department of Health (Department) oversees nursing home facilities in New York State through its Division of … State regulations and procedures for conducting nursing home surveys and whether survey processes, including the …
https://www.osc.ny.gov/state-agencies/audits/2018/03/08/nursing-home-surveillance-followAccounts Payable Advisory No. 3
… through regional offices located at various addresses in New York State (e.g., entities such as Time Warner Cable … These vendors and their unique requirements are included in the Guide to Financial Operations (GFO), Chapter XII - … to select an address on the Payments tab will result in the system populating the default address associated with …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/3-address-sequenceHolley Central School District – Financial Condition (2013M-342
… The purpose of our audit was to examine the District’s financial management practices for the period July 1, 2008 … District officials also improperly accounted for certain financial activity related to the capital projects fund, the … Holley Central School District Financial Condition 2013M342 …
https://www.osc.ny.gov/local-government/audits/school-district/2014/02/07/holley-central-school-district-financial-condition-2013m-342Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… whether Empire BlueCross BlueShield's (Empire) payments for certain special items were reasonable in relation to the … portion of the Empire Plan (Plan), which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughTheraCare Preschool Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by TheraCare … properly calculated and adequately documented pursuant to the State Education Department's Reimbursable Cost Manual … Background TheraCare provides special education services to children between the ages of three and five who live in …
https://www.osc.ny.gov/state-agencies/audits/2014/04/02/theracare-preschool-services-inc-compliance-reimbursable-cost-manualUnder Reporting of Net Available Monthly Income for Nursing Home Residents Causes Medicaid Overpayments (Follow-Up)
… Under Reporting of Net Available Monthly Income for Nursing Home Residents Causes Medicaid Overpayments (Report … September 28, 2011, examined whether Medicaid payments to nursing homes were properly reduced by Medicaid recipients' …
https://www.osc.ny.gov/state-agencies/audits/2013/08/16/under-reporting-net-available-monthly-income-nursing-home-residents-causes-medicaidMaximus, Inc.
… of the original contract. The services were related to the New York Health Benefit Exchange, and were not subject to … the total contract amount to $605 million and extended the life of the contract to August 19, 2017. Key Findings The … DOH will save nearly $21 million over the remaining life of the contract. This includes savings of: $11.5 million …
https://www.osc.ny.gov/state-agencies/audits/2014/05/06/maximus-incAlbany Leadership Charter High School for Girls – Professional Services (2013M-283)
… Albany Leadership Charter High School for Girls Professional Services 2013M283 …
https://www.osc.ny.gov/local-government/audits/charter-school/2014/01/17/albany-leadership-charter-high-school-girls-professional-services-2013mCrossroads Center for Children – Compliance With the Reimbursable Cost Manual
… determine whether the costs reported by Crossroads Center for Children, (Crossroads) on its Consolidated Fiscal Report … 30, 2014. Background Crossroads is an SED-approved, not-for-profit organization located in Schenectady, New York. … the ages of three and five years. Crossroads is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/crossroads-center-children-compliance-reimbursable-cost-manualOpinion 91-28
… the payment of refunds to consumers" (see also NY Const, art 14, §1[f]). In our opinion, the reference to "profits" in section 94 …
https://www.osc.ny.gov/legal-opinions/opinion-91-28Bilinguals Inc. – Compliance With the Reimbursable Cost Manual
… referred to as the Programs) to children residing in New York City as well as Nassau, Suffolk and Westchester … providers based on the financial information reported in their CFRs. For the three fiscal years ended June 30, … Bilinguals' Programs reported a total of $13.3 million in reimbursable costs. Key Findings We identified $875,729 in …
https://www.osc.ny.gov/state-agencies/audits/2014/06/26/bilinguals-inc-compliance-reimbursable-cost-manualMedicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… Purpose To identify Medicaid overpayments made to medical providers for services rendered to recipients enrolled in UnitedHealthcare’s Medicare Advantage plan: UnitedHealthcare Dual Complete. The … Advantage Plans typically have networks of participating providers they reimburse directly for services provided to …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsLow Income Home Energy Assistance Program – Federal Funding and New York
… The Low Income Home Energy Assistance Program, commonly referred to as HEAP, is designed to assist income eligible households … services, carbon monoxide detectors, chimney cleaning, as well as cooling assistance benefits. In FFY 2024, New York … The Low Income Home Energy Assistance Program commonly referred …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/low-income-home-energy-assistance-programDiNapoli Announces Scheduled Sale of $541M State of New York General Obligation Bonds
… details of the upcoming New York state General Obligation bond issue totaling $541.1 million. A competitive sale of … projects authorized by the following voter-approved bond acts: Pure Waters, Environmental Quality (1972), … projects authorized by the following voter-approved bond acts: Clean Water/Clean Air (1996), Rebuild and Renew …
https://www.osc.ny.gov/press/releases/2025/03/dinapoli-announces-scheduled-sale-541m-state-new-york-general-obligation-bondsMetro Therapy, Inc. – Compliance With the Reimbursable Cost Manual
… on the Consolidated Fiscal Reports (CFRs) of Metro Therapy, Inc. (Metro Therapy) were calculated properly, documented adequately, and … three fiscal years ended June 30, 2011. Background Metro Therapy is based in Hauppauge, New York and provides Special … reported on the Consolidated Fiscal Reports CFRs of Metro Therapy Inc Metro Therapy were calculated properly documented …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/metro-therapy-inc-compliance-reimbursable-cost-manualPawling Central School District – Selected Financial Activities (2012M-185)
… paid approximately $579,300 in tax certiorari claims from July 1, 2009 through June 30, 2012 from the general fund instead of using the tax certiorari … capital projects that includes a requirement for a written plan that clearly defines the scope of the project, sources …
https://www.osc.ny.gov/local-government/audits/school-district/2013/02/08/pawling-central-school-district-selected-financial-activities-2012m-185Summit Educational Resources – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Summit Educational Resources (Summit) on its Consolidated Fiscal Report (CFR) were properly … covered the fiscal year ended June 30, 2013. Background Summit provides a wide range of services to children with … To determine whether the costs reported by Summit Educational Resources Summit on its Consolidated …
https://www.osc.ny.gov/state-agencies/audits/2015/07/22/summit-educational-resources-compliance-reimbursable-cost-manualAmusement Park and Fair Ride Safety
… timing of our testing which inhibited us from conducting site visits during most of the operating season, precluded us … during the 2014 operating season. Key Finding We conducted site visits at 53 locations across the State covering almost …
https://www.osc.ny.gov/state-agencies/audits/2014/10/06/amusement-park-and-fair-ride-safetyPerformance Based Bus Safety Program
… has effectively implemented the Performance Based Bus Safety Program (Program) by focusing sufficiently … the Department to conduct a safety inspection of each bus every six months. In October 2013, the Department began to implement the Program by revising its bus inspection program to focus less on high-performing …
https://www.osc.ny.gov/state-agencies/audits/2016/03/17/performance-based-bus-safety-program