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Maximizing Drug Rebates Under the Federal Medicaid Drug Rebate Program (Follow-Up)
… of implementation of the 12 recommendations included in our initial audit report, Medicaid Program – Maximizing … administers the Medicaid program. For recipients enrolled in fee-for-service Medicaid, DOH makes payments for services … directly to health care providers. For recipients enrolled in managed care, DOH pays managed care organizations (MCOs) a …
https://www.osc.ny.gov/state-agencies/audits/2024/12/20/maximizing-drug-rebates-under-federal-medicaid-drug-rebate-program-followUtilization of the Arch Street Yard and Shop Facility
… Authority (MTA) – Long Island Rail Road (LIRR) Arch Street Yard and Shop Facility (Facility) was constructed before it … Transportation Authority Long Island Rail Road Arch Street Yard and Shop Facility Facility was constructed before …
https://www.osc.ny.gov/state-agencies/audits/2017/12/08/utilization-arch-street-yard-and-shop-facilityMedicaid Program – Maximizing Drug Rebates for Health and Recovery Plans
… October 1, 2015 through December 31, 2017. Background In 1990, Congress created the Medicaid Drug Rebate Program to … federal expenditures for Medicaid prescription drug costs. In January 1991, New York’s Medicaid program began requesting … to the manufacturers. The Affordable Care Act, enacted in 2010, extended prescription drug rebates to cover …
https://www.osc.ny.gov/state-agencies/audits/2018/06/22/medicaid-program-maximizing-drug-rebates-health-and-recovery-plansImproper Payments to a Physical Therapist (Follow-Up)
… Purpose To determine the extent of implementation of the two … included in our initial audit report, Improper Payments to a Physical Therapist ( Report 2013-S-15 ). Background The … To determine the extent of implementation of the two …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… of New York: Empire Plan Drug Rebate Revenue ( 2013-S-41 ). Background The New York State Health Insurance … with United HealthCare (United) to administer the Plan’s prescription drug program between January 1, 2008 and … Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-10) …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followSky Light Center Inc. – Supported Housing Program
… supported housing providers, such as Sky Light, to locate apartments and negotiate leases on behalf of clients, help the clients move into their apartments, and provide necessary related services. Sky Light … his personal property, and rental payments for unoccupied apartments. Sky Light officials cannot account for over …
https://www.osc.ny.gov/state-agencies/audits/2014/05/05/sky-light-center-inc-supported-housing-programOverpayments of Claims for Selected Professional Services (Follow-Up)
… report Overpayments of Claims for Selected Professional Ser …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followWage Theft Investigations
… its resources to undertake and complete wage theft investigations timely and whether these efforts are … and wage protection, the Division conducts wage theft investigations on behalf of workers who file wage dispute … Key Findings The Division does not complete wage theft investigations timely. As of August 26, 2013, the Division …
https://www.osc.ny.gov/state-agencies/audits/2014/06/06/wage-theft-investigationsMedicaid Program – Payments for Death-Related One-Day Inpatient Admissions
… effectively implemented and applied the new APR DRG-based hospital inpatient payment system for Medicaid services when … implemented to provide a more equitable payment method for hospital inpatient services and to better reflect the … For instance, Medicaid paid $153,329 on a claim with hospital charges totaling $9,685 for a patient who died …
https://www.osc.ny.gov/state-agencies/audits/2013/08/15/medicaid-program-payments-death-related-one-day-inpatient-admissionsService Diversions for Maintenance and Capital Projects
… safely access the tracks. Diversions should be scheduled in the most cost effective manner and to minimize the … Public Affairs is responsible for notifying the public in advance. Key Findings The annual Outage Plan for service diversions was reduced by 1,483 days (29 percent) in 2009 and 1,655 (35 percent) in 2010. These revisions were …
https://www.osc.ny.gov/state-agencies/audits/2014/03/18/service-diversions-maintenance-and-capital-projectsTechnology Transfer Program and Royalty Payments (Follow-Up)
… Transfer Program and Royalty Payments (Report 2019-S-10 ). About the Program As part of its duties, the Research …
https://www.osc.ny.gov/state-agencies/audits/2021/02/08/technology-transfer-program-and-royalty-payments-followAccountability and Surplussing of Vehicles (Follow-Up)
… Objective To determine the extent of implementation of the recommendations included in our initial audit report, Accountability and Surplussing of Vehicles ( 2018-S-42 ). Background The New York State … To determine the extent of implementation of the recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2021/05/27/accountability-and-surplussing-vehicles-followInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… During the initial audit period, Family Health Plus (FHP) was a publicly funded managed care program for … eliminated effective January 1, 2015 and the majority of FHP enrollees transitioned to the Medicaid program. Managed … payments to Medicaid mainstream managed care plans and FHP managed care plans for recipients who were no longer …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andEmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits
… EmblemHealth Plan, Inc. overpaid dental claims for members covered by two subscriber plans under the New York State Dental Insurance Program. The audit covered the period from January … use for paying health care claims when an individual is covered by more than one insurance plan. This process …
https://www.osc.ny.gov/state-agencies/audits/2024/01/08/emblemhealth-plan-inc-overpayments-services-requiring-coordination-benefitsNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
… of implementation of the four recommendations included in our initial audit report, New York State Health Insurance … NYBEAS disenrollment is entered after the date the change in eligibility takes effect, it is considered a retroactive … 2015 through December 2020. We identified $3.21 million in overpayments for services, which resulted primarily from …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andAccess Controls Over Selected Critical Systems
… in New York State. Its responsibilities encompass a wide range of social services programs, including: foster care and … Technology Services. OCFS’ systems contain a broad range of sensitive information that is considered …
https://www.osc.ny.gov/state-agencies/audits/2019/03/21/access-controls-over-selected-critical-systemsState Agencies Bulletin No. 1893
… of this bulletin is to describe new Time Entry Earnings Codes to be used to adjust overtime. Affected Employees … tracking of overtime adjustments in PayServ, new Earnings Codes have been created. Effective Dates Effective … OSC Actions OSC has created the following Earnings Codes in PayServ to be used in place of Earnings Code AJR to …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1893-reporting-adjustments-overtimeCity of Newburgh – Budget Review (B21-6-13)
… to maintain fund balance at a reasonable level to ensure funds are available in case of unanticipated expenditures or …
https://www.osc.ny.gov/local-government/audits/city/2021/11/10/city-newburgh-budget-review-b21-6-13DiNapoli: Local Sales Tax Collections in August Grew More Than 15 Percent
… $1.5 billion, up nearly $204 million from August of last year. “New York’s local governments continue to see much … New York City During the last month of each calendar quarter, the state Department of Taxation and Finance … had been reported by sales tax vendors for the reporting quarter and adjusts payments to local jurisdictions in those …
https://www.osc.ny.gov/press/releases/2021/09/dinapoli-local-sales-tax-collections-august-grew-more-15-percentDiNapoli: Local Sales Tax Collections Increase by 3.6% in Third Quarter Over Last Year
… returning to lower pre-pandemic year-over-year growth rates. “Year-over-year growth in local sales tax collections … at 35.9%, while Auburn had the biggest decline at -6.5%. Gas Collections Slightly Up: Despite gas prices declining 9.5% in the third quarter of 2023 …
https://www.osc.ny.gov/press/releases/2023/10/dinapoli-local-sales-tax-collections-increase-3-point-6-percent-third-quarter-over-last-year