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An Analysis of Reasonable and Customary Out-of-Network Reimbursement Rates for Medical/Surgical Services in the New York State Health Insurance Program (2018-D-2)
The New York State Health Insurance Program (NYSHIP), administered by the State Department of Civil Service (Civil Service), is one of the nation's largest...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-18d2.pdfState Comptroller DiNapoli Releases Audits
… costs that did not comply with requirements for state reimbursement, including $541,775 paid to 38 individuals who …
https://www.osc.ny.gov/press/releases/2018/12/state-comptroller-dinapoli-releases-audits-0DiNapoli: Former Pharmacist Charged In $232,000 Medical Claims Fraud
… for allegedly sending phony prescription records for reimbursement to Medicaid and the New York State Health …
https://www.osc.ny.gov/press/releases/2015/09/dinapoli-former-pharmacist-charged-232000-medical-claims-fraudDiNapoli: Oil Spill Fund Reaches New Agreements With St. Lawrence County
… financial losses when the spiller will not and to seek reimbursement from spillers for oil spill cleanup costs. The …
https://www.osc.ny.gov/press/releases/2018/08/dinapoli-oil-spill-fund-reaches-new-agreements-st-lawrence-countyState Comptroller DiNapoli Releases State Audits
… auditors identified $167,041 in costs claimed for state reimbursement that did not comply with requirements and …
https://www.osc.ny.gov/press/releases/2017/12/state-comptroller-dinapoli-releases-state-auditsKids-Centric, Inc. – Compliance With the Reimbursable Cost Manual
… adjustments to Kids-Centric’s CFRs and to Kids-Centric’s reimbursement rates. Work with Kids-Centric officials to help …
https://www.osc.ny.gov/state-agencies/audits/2015/12/30/kids-centric-inc-compliance-reimbursable-cost-manualSelected Employee Travel Expenses
… all the toll charges for personal trips are identified for reimbursement. Ensure that the mileage for all non-business …
https://www.osc.ny.gov/state-agencies/audits/2014/02/25/selected-employee-travel-expensesPipeline Safety Oversight
… some of its authority to states and provides partial reimbursement for the costs they incur. In New York, the PSC …
https://www.osc.ny.gov/state-agencies/audits/2016/03/08/pipeline-safety-oversightNew York City School-Based Health Centers – Security and Controls Over Medications and Related Supplies
… SBHCs bill Medicaid and third-party insurance for reimbursement, as appropriate. All SBHCs must provide, …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/new-york-city-school-based-health-centers-security-and-controls-over-medications-andUnited Community Services, Inc. – Compliance With the Reimbursable Cost Manual
… costs reported on United’s CFRs and to United’s tuition reimbursement rates. Work with United officials to help …
https://www.osc.ny.gov/state-agencies/audits/2015/12/30/united-community-services-inc-compliance-reimbursable-cost-manualImproper Supplemental Maternity Capitation Payments to Managed Care Organizations (Follow-Up)
… data to verify that SMCP claims were eligible for reimbursement. Instead, the Department relied on audits by …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/improper-supplemental-maternity-capitation-payments-managed-care-organizations-followAudit Finds Operational and Oversight Failures Led to Financial Instability in Mount Vernon
… and retained outside counsel, and then failed to seek reimbursement for more than $7,500 in payments to this …
https://www.osc.ny.gov/press/releases/2022/01/audit-finds-operational-and-oversight-failures-led-financial-instability-mount-vernonCanarsie Childhood Center, Inc. – Compliance With the Reimbursable Cost Manual
… to the costs reported on CCC’s CFRs and to CCC’s tuition reimbursement rates, as warranted. Remind CCC officials of …
https://www.osc.ny.gov/state-agencies/audits/2022/02/01/canarsie-childhood-center-inc-compliance-reimbursable-cost-manualE&D Children Center, Inc. – Compliance With the Reimbursable Cost Manual
… to the costs reported on E&D’s CFR and to E&D’s tuition reimbursement rates, as warranted. Remind E&D officials of …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/ed-children-center-inc-compliance-reimbursable-cost-manualEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012
… hospitals contain language that: specifies the basis of reimbursement for the purchase and acquisition of special …
https://www.osc.ny.gov/state-agencies/audits/2013/12/13/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughPositive Beginnings, Inc. – Compliance With the Reimbursable Cost Manual
… Beginnings’ CFRs and to Positive Beginnings’ tuition reimbursement rates, as warranted. Remind Positive Beginnings …
https://www.osc.ny.gov/state-agencies/audits/2024/03/13/positive-beginnings-inc-compliance-reimbursable-cost-manualStep Up Therapy Services, PLLC – Compliance With the Reimbursable Cost Manual
… costs reported on Step Up’s CFRs and to Step Up’s tuition reimbursement rates, as warranted. Remind Step Up officials …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/step-therapy-services-pllc-compliance-reimbursable-cost-manualForms and Publications
… Wire Extension Request Form Handbook for Reporters of Unclaimed Funds OFAC Blocked Accounts - reference section on Blocked Accounts Property Type Table Report of Abandoned Property (AC 2686 …
https://www.osc.ny.gov/unclaimed-funds/resources/forms-and-publicationsMedicaid Program – Medicaid Claims Processing Activity October 1, 2017 Through March 31, 2018
… had; $2.1 million was paid for claims involving the Medicare Savings Program; $1.7 million in fee-for-service …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/medicaid-program-medicaid-claims-processing-activity-october-1-2017-through-march-31-2018CUNY Bulletin No. CU-555
… Ed Repay State Loan 445 HC Flexible Spending 580 CUNY Medicare Deficiency Flat Rate 581 CUNY Social Security …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-555-cuny-rate-increases-auto-mechanic-and-machinist