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Medicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… Organization (IPRO), to review claims. We coordinated with the Department and IPRO to review a judgmental sample of … 248 days. If the hospital billed this admission correctly (with 248 days at the ALC rate), Medicaid would have paid only …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissionsDual Employment
… DOCCS sometimes allows employees to work full-time at one facility and then work additional time at another facility (referred to as extra service), or may allow them to … were concurrently employed by either more than one DOCCS facility or a DOCCS facility and another government agency, …
https://www.osc.ny.gov/state-agencies/audits/2013/12/19/dual-employment-2Corcraft's Textile Procurement Practices
… Background The Division of Industries, known as Corcraft, is a major component within the Department of Corrections and Community Supervision. Corcraft's mission is to employ offenders in real work situations to produce …
https://www.osc.ny.gov/state-agencies/audits/2014/05/16/corcrafts-textile-procurement-practicesCriminal History Background Checks of Unlicensed Health Care Employees
… its Criminal History Record Check (CHRC) Legal Unit, is responsible for conducting criminal history background … a fingerprint request on behalf of the applicant if he/she has not previously been submitted through CHRC. These … denied employment eligibility. Key Findings The Department is generally meeting its obligations for conducting …
https://www.osc.ny.gov/state-agencies/audits/2017/06/08/criminal-history-background-checks-unlicensed-health-care-employeesAccounts Payable Advisory No. 29
… certify to the Comptroller annually, or at any time there is a new head of the agency, that the agency has sufficient … for that certification. This certification requirement is separate and distinct from DOB’s annual Internal Control …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/29-internal-controls-certificationCanarsie Childhood Center, Inc. – Compliance With the Reimbursable Cost Manual
… 2 fiscal years ended June 30, 2017. About the Program CCC is a New York City-based proprietary organization authorized … Class Program. For purposes of this report, this program is referred to as the cost-based program. Payments for …
https://www.osc.ny.gov/state-agencies/audits/2022/02/01/canarsie-childhood-center-inc-compliance-reimbursable-cost-manualPurchasing and Procurement Practices
… December 2020. About the Program Organized in 1955, NYRA is a not-for-profit corporation that holds the exclusive … procurement process; consequently, sufficient competition is not fully promoted, and overspending may have occurred. …
https://www.osc.ny.gov/state-agencies/audits/2022/03/16/purchasing-and-procurement-practicesMedicaid Program – Improper Overlapping Medicaid and Essential Plan Enrollments
… people who, generally, don’t otherwise qualify for Medicaid. As income, household makeup, and other factors … organized under the Department where individuals can apply for and enroll in health insurance plans, including Medicaid … on information from NYSOH to accurately make payments for the Medicaid and EP programs. Key Findings The audit …
https://www.osc.ny.gov/state-agencies/audits/2022/10/11/medicaid-program-improper-overlapping-medicaid-and-essential-plan-enrollmentsOversight of Telemental Health Services (Follow-Up)
… ). About the Program The Office of Mental Health (OMH) is responsible for developing regulations and providing … including the use of telemental health (TMH). TMH is a voluntary treatment method that makes use of two-way, …
https://www.osc.ny.gov/state-agencies/audits/2022/12/06/oversight-telemental-health-services-followHousing Trust Fund Corporation – Oversight of the Residential Emergency Services to Offer Home Repairs to the Elderly Program
… including the Housing Trust Fund Corporation (HTFC), which is responsible for community development through the … Within HTFC, the Office of Community Renewal (OCR) is responsible for administering the RESTORE program, which …
https://www.osc.ny.gov/state-agencies/audits/2021/07/15/housing-trust-fund-corporation-oversight-residential-emergency-services-offer-home-repairsMedicaid Program – Cost Saving Opportunities on Payments of Medicare Part C Claims
… claim types reviewed by this audit: outpatient claims for clinic, practitioner, transportation, referred ambulatory, … durable medical equipment, laboratory, eye care, and dental services; and inpatient claims. Key Findings New …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-cost-saving-opportunities-payments-medicare-part-c-claimsControls Over Transportation Services and Transportation-Related Expenses
… OPWDD could take additional steps to monitor employee driving records and require training or counseling for employees with poor driving records to ensure the safety of individuals it … does not have controls in place to educate or improve driving skills for employees with frequent driver license …
https://www.osc.ny.gov/state-agencies/audits/2020/07/28/controls-over-transportation-services-and-transportation-related-expensesOversight of Managed Long-Term Care Member Eligibility (Follow-Up)
… for initiating disenrollment of enrollees when it is determined they are no longer MLTC eligible (e.g., … services in a month or deceased recipients), and Maximus is responsible for processing the disenrollments. The …
https://www.osc.ny.gov/state-agencies/audits/2024/03/13/oversight-managed-long-term-care-member-eligibility-followControls Over Capital Improvements at City-Owned Homeless Shelters (Follow-Up)
… of the New York City Department of Social Services (DSS), is the oversight authority responsible for providing … for shelter improvement projects. DHS’ capital budget is mainly used to repair and improve its shelters and other …
https://www.osc.ny.gov/state-agencies/audits/2023/03/22/controls-over-capital-improvements-city-owned-homeless-shelters-followStep Up Therapy Services, PLLC – Compliance With the Reimbursable Cost Manual
… years ended June 30, 2014. About the Program Step Up is a New York City-based not-for-profit organization approved … 3 and 5 years. For purposes of this report, this program is referred to as the SED preschool cost-based program. Step …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/step-therapy-services-pllc-compliance-reimbursable-cost-manualImproper Supplemental Maternity Capitation Payments to Managed Care Organizations (Follow-Up)
… 2020-S-57 ). About the Program The Medicaid program is administered by the Department of Health (Department). … the monthly premium for the recipient. Further, an MCO is only eligible to receive the SMCP if it submits encounter …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/improper-supplemental-maternity-capitation-payments-managed-care-organizations-followOversight of Campus Foundations (Follow-Up)
… to contract with foundations, which are private, not-for-profit corporations, to support fundraising efforts, real … of SUNY’s System Administration (SSA). OUA is responsible for conducting periodic audits of the foundations, while UCO is responsible for ensuring the foundations have the required contracts with …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/oversight-campus-foundations-followThe 80/20 Housing Program (Follow-Up)
… audit report concluded that, based on the rents charged for our four sampled developments, the proper number of … available to low-income tenants. Our review of the files for a sample of 43 low-income tenants found that, in most … "reasonable judgment" in determining eligibility. However, for 4 of the 43 tenants, we question whether the developers …
https://www.osc.ny.gov/state-agencies/audits/2018/11/13/8020-housing-program-followMonitoring Town Asphalt Road Projects (2012MS-7)
… of wages and supplements for the locality where the work is performed. The Law requires the vendor to submit certified … the asphalt vendor to help ensure that the HMA received is what the Town contractually agreed to purchase. Revise …
https://www.osc.ny.gov/local-government/audits/statewide-audit/2013/04/05/monitoring-town-asphalt-road-projects-2012ms-7City of Amsterdam - Budget Review (B22-5-3)
… with the fiscal year during which the municipality is authorized to issue the deficit obligations, and for each … proposed budget includes a tax levy of $6,219,084, which is within the limit. Key Recommendations Develop a plan to …
https://www.osc.ny.gov/local-government/audits/city/2022/04/27/city-amsterdam-budget-review-b22-5-3