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New York State Health Insurance Program - Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (2022-S-24)
To determine whether CVS Caremark paid claims under the correct prescription drug plan.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22s24.pdfNew York State Health Insurance Program: Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (2021-S-18) 180-Day Response
To determine whether Beacon Health Options paid mental health and substance abuse (MHSA) claims for Empire Plan members who were not eligible for coverage.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-21s18-response2.pdfNew York State Health Insurance Program: Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (2021-S-18) 180-Day Response
To determine whether Beacon Health Options paid mental health and substance abuse (MHSA) claims for Empire Plan members who were not eligible for coverage.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-21s18-response1.pdfJohn A. Coleman School – Compliance With the Reimbursable Cost Manual
… three fiscal years ended June 30, 2011. Background Coleman is located in White Plains and Yonkers, New York and provides …
https://www.osc.ny.gov/state-agencies/audits/2013/08/05/john-coleman-school-compliance-reimbursable-cost-manualMedicaid Program – Claims Processing Activity October 1, 2018 Through March 31, 2019
… Objective To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … with Medicaid requirements, and resulted in correct payments to the providers. The audit covered the period …
https://www.osc.ny.gov/state-agencies/audits/2019/09/27/medicaid-program-claims-processing-activity-october-1-2018-through-march-31-2019DiNapoli: Farms Generated $5.7 Billion for New York Economy
… Thomas P. DiNapoli. “Agriculture is an essential part of New York’s economy,” DiNapoli said. “Farms generate billions of dollars in sales, provide jobs and enhance our quality of life. But farmers face challenges including fluctuating …
https://www.osc.ny.gov/press/releases/2019/08/dinapoli-farms-generated-57-billion-new-york-economyMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… Purpose To determine if the Department of Health overpaid health care … supplemental insurance benefits for services that are not covered by original Medicare (e.g., dental services). … deductibles and coinsurance). If Plans deny a claim or pay a different amount than what a provider billed, Plans …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesHawthorne Foundation, Inc. – Compliance With the Reimbursable Cost Manual
… provides preschool special education services to children with disabilities who are between three and five years of … be eligible for reimbursement, reported costs must comply with RCM requirements. For the fiscal year ended June 30, … Hawthorne did not disclose related-party transactions with three entities on its CFR, as required. Key …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/hawthorne-foundation-inc-compliance-reimbursable-cost-manualInterdisciplinary Center for Child Development – Compliance With the Reimbursable Cost Manual
… whether the costs reported by the Interdisciplinary Center for Child Development (ICCD) on its Consolidated Fiscal … audit focused primarily on expenses claimed on ICCD’s CFR for the fiscal year ended June 30, 2015, and included certain expenses claimed on ICCD’s CFRs for the two fiscal years ended June 30, 2014. Background ICCD …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/interdisciplinary-center-child-development-compliance-reimbursable-cost-manualApplying for Previous or Military Service Credit – New Career Plan for ERS Tier 2 Members
… covered by Sections 75h and 75i Applying for Previous or Military Service Credit …
https://www.osc.ny.gov/retirement/publications/1509/applying-previous-or-military-service-creditReceiving Your Benefit and Filing Your Option Election – Career Plan for ERS Tier 2 Members
… 75f and 75g Receiving Your Benefit and Filing Your Option Election …
https://www.osc.ny.gov/retirement/publications/1508/receiving-your-benefit-and-filing-your-option-electionAdditional Service Credit for Sick Leave (Section 41[j]) – Career Plan for ERS Tier 2 Members
Career Plan information for ERS Tier 2 members covered by Sections 75f and 75g Additional Service Credit for Sick Leave Section 41j
https://www.osc.ny.gov/retirement/publications/1508/additional-service-credit-sick-leave-section-41jCredit for Previous Public Employment or Military Service – Career Plan for ERS Tier 2 Members
… covered by Sections 75f and 75g Credit for Previous Public Employment or Military Service …
https://www.osc.ny.gov/retirement/publications/1508/credit-previous-public-employment-or-military-serviceMedicaid Program – Medicaid Claims Processing Activity April 1, 2017 Through September 30, 2017
… were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit … for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for … of more than $31 billion. The claims are processed and paid in weekly cycles, which averaged over 7.4 million …
https://www.osc.ny.gov/state-agencies/audits/2018/08/03/medicaid-program-medicaid-claims-processing-activity-april-1-2017-through-september-30-2017Children’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual
… About the Program CUTE, an SED-approved provider located in Broome County, New York, provides preschool special … June 30, 2016, CUTE reported approximately $1.8 million in reimbursable costs for the Preschool Special Class that it … fiscal years ended June 30, 2016, we identified $232,606 in reported costs that did not comply with the RCM’s …
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
The objectives of our examination were to determine whether i Unemployment Insurance UI benefit payments approved by the Department of Labor Department w
https://www.osc.ny.gov/state-agencies/audits/2018/11/19/department-labor-examination-unemployment-insurance-benefit-payments-january-1-2017Amerimed Kids, LLC – Compliance With the Reimbursable Cost Manual
… Education Itinerant Teacher (SEIT) services to children with disabilities who are between the ages of three and five … Amerimed Kids shares office space and certain employees with the private business and the EI program. We repeatedly … to the SEIT program. These requests were not complied with. During the 2014-15 school year, Amerimed Kids served …
https://www.osc.ny.gov/state-agencies/audits/2019/06/05/amerimed-kids-llc-compliance-reimbursable-cost-manualAssociation to Benefit Children – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the Association to … the fiscal year ended June 30, 2014. Background ABC is a not-for-profit State-approved private school established in 1986. ABC is approved by SED to operate preschool Special …
https://www.osc.ny.gov/state-agencies/audits/2019/02/08/association-benefit-children-compliance-reimbursable-cost-manualDiNapoli: Health Care Jobs Grow Across New York
… of the total, New York ranked third in the nation for its share of health care jobs. Growth in private sector … wages than the rest of the private sector. In the North Country, average annual wages in health care were more than … Find out how your government money is spent at Open Book New York . …
https://www.osc.ny.gov/press/releases/2018/10/dinapoli-health-care-jobs-grow-across-new-yorkNiagara Charter School - Information Technology (2018M-172)
… private and sensitive information (PPSI) on, or accessed by, the School’s information technology (IT) assets is … personal private and sensitive information on or accessed by the Schools information technology assets is properly …
https://www.osc.ny.gov/local-government/audits/charter-school/2018/12/21/niagara-charter-school-information-technology-2018m-172