Search
Overpayments of Certain Medicare Crossover Claims
To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify the claims processing control weaknesses
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsLeague for the Handicapped – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the League for the … services. LFH offers a range of services and programs to children with disabilities from birth through eight years … In 2014, LFH provided preschool special education services to 156 children with learning disabilities from approximately …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/league-handicapped-compliance-reimbursable-cost-manualEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… portion of the Plan. Empire processes and pays claims for hospital services in accordance with agreements Empire negotiates with member hospitals. Payments for hospital services are generally based on standard fee … payments for special items are made in accordance with hospital agreements, and made significant progress to ensure …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… Purpose To determine whether Medicaid made improper fee-for-service claim payments for … October 1, 2011 through December 31, 2013. Background Medicaid provides a wide range of medical services to those … and/or have special health care needs. In general, the Medicaid program pays medical providers through either the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careSelected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Empire BlueCross and BlueShield)
… which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member hospitals. Payments for hospital services are generally based on standard fee …
https://www.osc.ny.gov/state-agencies/audits/2014/01/16/selected-payments-special-items-period-july-1-2012-through-december-31-2012-empireMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… who were transferred between merged or consolidated hospitals and whether corresponding overpayments occurred. … include establishing Medicaid policies for reimbursing hospitals and other health care providers for their services. … when a Medicaid recipient is transferred among different hospitals, two separate payments are made: a payment for the …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilitiesJohn A. Coleman School – Compliance With the Reimbursable Cost Manual
… A. Coleman School (Coleman) on its Consolidated Fiscal Reports (CFRs) were properly calculated, adequately … that are allowed by the Manual. Other Related Audits/Reports of Interest State Education Department: Bilingual … John A Coleman School Coleman on its Consolidated Fiscal Reports CFRs were properly calculated …
https://www.osc.ny.gov/state-agencies/audits/2013/08/05/john-coleman-school-compliance-reimbursable-cost-manualSelected Aspects of the Motor Carrier Safety Assistance Program
… to have violations serious enough to warrant their removal from service are making appropriate, timely repairs or … identify violations, carriers typically receive a traffic citation. However, inspections sometimes uncover … Instead, violators in these instances typically received a traffic citation. Key Recommendations Actively monitor …
https://www.osc.ny.gov/state-agencies/audits/2014/01/22/selected-aspects-motor-carrier-safety-assistance-programMedicaid Program – Accuracy of Medicaid Eligibility Determined by NY State of Health
… Objective To determine whether NY State of Health (NYSOH, New York’s online health plan marketplace) … February 28, 2020. About the Program The Department of Health (Department) administers New York’s Medicaid program. Many of the State’s Medicaid recipients receive their services …
https://www.osc.ny.gov/state-agencies/audits/2020/09/17/medicaid-program-accuracy-medicaid-eligibility-determined-ny-state-healthMedicaid Program – Claims Processing Activity October 1, 2021 Through March 31, 2022
… Objective To determine whether the Department of Health’s … (Department’s) eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were processed in … To determine whether the Department of Healths Departments eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers were …
https://www.osc.ny.gov/state-agencies/audits/2022/12/13/medicaid-program-claims-processing-activity-october-1-2021-through-march-31-2022Cyber Incident Response Team (Follow-Up)
… in our initial audit report, Cyber Incident Response Team (Report 2020-S-58 ). About the Program Cybercrimes … Crime Report. In 2017, the Cyber Incident Response Team (CIRT) was created within the Division of Homeland … in our initial audit report Cyber Incident Response Team Report 2020S58 …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/cyber-incident-response-team-followMedicaid Program – Improper Medicaid Payments During Permissible Overlapping Medicaid and Essential Plan Coverage
… Medicaid and Essential Plan coverage. The audit covered the period from January 2017 through November 2022. … New York’s Essential Plan, which provides health insurance to lower-income individuals who, generally, don’t … Approximately $69 million for health care services fully covered by the Essential Plan; Up to $14.1 million for health …
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-improper-medicaid-payments-during-permissible-overlapping-medicaid-andEmpire BlueCross – Overpayments for Physician-Administered Drugs
… The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million of these members. … of the Empire Plan. Empire processes and pays claims for hospital services, which includes coverage for inpatient and outpatient services provided by a hospital, …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/empire-bluecross-overpayments-physician-administered-drugsSelected Safety and Security Equipment at Train Stations (Follow-Up)
… 15, 2019, SIR had 199 Closed Circuit Television (CCTV) cameras, 44 stand-alone local cameras, and 45 Customer … technicians perform preventive maintenance and repairs on safety and security equipment such as CCTV cameras, CAIs, … for surveillance and security purposes. CCTV relies on strategic placement of cameras and the off-site …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/selected-safety-and-security-equipment-train-stations-followComptroller DiNapoli Releases Municipal Audits
… Town of Deerpark , City of Newburgh and Rockland County . “In today’s fiscal climate, budget transparency and … provide the board with adequate monthly financial reports. In addition, the board did not have adequate procedures for … Consequently, the board did not audit and approve claims in accordance with town law for 20 of the 100 check …
https://www.osc.ny.gov/press/releases/2016/11/comptroller-dinapoli-releases-municipal-audits-0Government-Wide Financial Data – 2023 Financial Condition Report
… This statement reports: Assets; Deferred outflows of resources (the consumption of net assets applicable to a … future reporting period); Liabilities; Deferred inflows of resources (the acquisition of net assets applicable to a … and The difference between assets and deferred outflows of resources, and liabilities and deferred inflows of resources …
https://www.osc.ny.gov/reports/finance/2023-fcr/government-wide-financial-dataNY State Comptroller DiNapoli Statement on Pension Fund's Ranking as Top U.S. Investor Battling Climate Risk
… Project named the New York State Common Retirement Fund as the number one U.S. pension fund, and the third globally, for its work to address climate … Project named the New York State Common Retirement Fund as the number one US pension fund and the third globally …
https://www.osc.ny.gov/press/releases/2018/09/ny-state-comptroller-dinapoli-statement-pension-funds-ranking-top-us-investor-battling-climate-riskComptroller DiNapoli Releases School District Audits
… for individuals who used the district’s IT assets. In addition, personal internet use was found on computers … revenues. Auditors found that $4.2 million was maintained in the debt service fund although the funds had not been designated to pay debt. In addition, district officials improperly restricted funds …
https://www.osc.ny.gov/press/releases/2020/03/comptroller-dinapoli-releases-school-district-auditsMontgomery County – Financial Condition (2013M-234)
… on appropriating fund balance, a non-recurring revenue, to finance recurring expenditures. Further, in two of the last … balance of $19.2 million. We also found that the County’s cash-on-hand declined from twice its average monthly … to fund County operations. Regularly monitor cash flow and use cash flow information as a part of the budget …
https://www.osc.ny.gov/local-government/audits/county/2013/10/04/montgomery-county-financial-condition-2013m-234Allegany County Industrial Development Agency – Internal Controls Over Selected Financial Activities (2012M-244)
… for certain projects from January 1, 2008, to August 31, 2012. Background The overall goal of IDAs is to advance the …
https://www.osc.ny.gov/local-government/audits/industrial-development-agency/2013/05/31/allegany-county-industrial-development-agency-internal