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Maximizing Drug Rebates Under the Federal Medicaid Drug Rebate Program (Follow-Up)
… managed care, DOH pays managed care organizations (MCOs) a monthly premium for each enrolled recipient, and the MCOs … The MDRP requires drug manufacturers to enter into a national rebate agreement with the Centers for Medicare & … rebates totaling $183.7 million due to errors in DOH’s claim extraction procedures, inaccurate or incomplete claim …
https://www.osc.ny.gov/state-agencies/audits/2024/12/20/maximizing-drug-rebates-under-federal-medicaid-drug-rebate-program-followMedicaid Program – Medicaid Claims Processing Activity April 1, 2017 Through September 30, 2017
… Purpose To determine whether the Department of Health's eMedNY system reasonably ensured that Medicaid … Medicaid requirements, and resulted in correct payments to the providers. The audit covered the period April 1, 2017 … To determine whether the Department of Healths eMedNY system reasonably ensured …
https://www.osc.ny.gov/state-agencies/audits/2018/08/03/medicaid-program-medicaid-claims-processing-activity-april-1-2017-through-september-30-2017Medicaid Program – Medicaid Claims Processing Activity April 1, 2016 Through September 30, 2016
… system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for their claims. During the six-month period ended September … with end stage renal disease who were entitled to Medicare coverage at the time of the claims; $1.1 million in …
https://www.osc.ny.gov/state-agencies/audits/2017/07/25/medicaid-program-medicaid-claims-processing-activity-april-1-2016-through-september-30-2016Examination of Superstorm Sandy Expenses
… response to the Sandy disaster, DHSES paid $1.17 million for 1,000 portable Pelican LED lights, 1,000 portable … this equipment to additional locations (e.g., firehouses) for other Sandy relief efforts. Key Findings We found DHSES … future emergencies. Recover outstanding generators or seek reimbursement for items not returned. Determine if DHSES …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/examination-superstorm-sandy-expensesXIX.3 Project IDs with Multiple Funding Sources – XIX. Project Costing (PCIP)
… sources, considering the following questions: What is my total project budget? What is my total project cost? Encumbrance? What is my federal versus state match spending? What are my complete …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xix/xix3-project-ids-multiple-funding-sourcesUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Follow-Up)
… The Empire Plan is the primary health benefits plan for NYSHIP. Civil Service contracted with UnitedHealthcare … visit). The higher the level billed, the greater United’s reimbursement. Billing for a higher level of care than the service actually provided …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesState Comptroller DiNapoli Releases School District Audits
… oversight was lacking. Officials did not provide support for 12 of the 15 balance sheet accounts auditors reviewed. … in a timely manner. Only four of the 349 journal entries for 2018-19 and only 60 of the 292 journal entries for 2019-20 were recorded during each year. Officials also …
https://www.osc.ny.gov/press/releases/2021/07/state-comptroller-dinapoli-releases-school-district-auditsSelected Employee Travel Expenses
… 2011. Of that amount, about $3,482,478 (20 percent) was for charges on State-issued travel cards, and $13,520,915 (80 percent), was for reimbursement to employees for travel expenses not …
https://www.osc.ny.gov/state-agencies/audits/2013/09/04/selected-employee-travel-expensesCollege of Plattsburgh – Selected Employee Travel Expenses
… citizenship, and ethical life based on a strong foundation in the liberal arts. The College spent $2,867,155 on travel … focused their audit efforts on the highest cost travelers in the State, each of whom incurred over $100,000 in travel expenses during the three-year period, as well as …
https://www.osc.ny.gov/state-agencies/audits/2013/04/25/college-plattsburgh-selected-employee-travel-expensesLife Changes: Getting Your Affairs in Order and A Guide for Survivors
… can do now to ensure your loved ones will have the information they need in the future. The second section is … to your survivors. By taking some time today to prepare for the future, you will make a difficult time a little less … Information for survivors on preparing for the future …
https://www.osc.ny.gov/retirement/publications/getting-your-affairs-order-and-guide-survivorsManaged Care Organizations – Payments to Ineligible Providers (Follow-Up)
… or regulatory requirements related to the Medicaid or Medicare programs or who have engaged in other unacceptable … payments from Medicaid Managed Care Organizations (MCOs) for services rendered to Medicaid recipients. We issued our … review. The Department obtained the missing provider IDs for 19.3 million of the 22.5 million claims, and the Office …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/managed-care-organizations-payments-ineligible-providers-followImproper Payments Related to the Medicare Buy-In Program (Follow-Up) (2014-F-12)
We have followed up on the actions taken by officials of the Department of Health to implement the recommendations contained in our audit report, Improper
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-14f12.pdfAnthem Blue Cross – Coordination of Benefits With Medicare (Follow-Up) (2025-F-25)
To assess the extent of implementation of the four recommendations included in our initial audit report, Anthem Blue Cross – Coordination of Benefits With Medicare (Report 2023-S-30).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2026-25f25.pdfMetro Therapy, Inc. – Compliance With the Reimbursable Cost Manual
… on financial information reported on the providers’ CFRs. For the three fiscal years ended June 30, 2011, Metro Therapy … in non-reimbursable costs. Among the costs we recommend for disallowance are: $357,063 in excessive allocations of … Metro Therapy’s CFRs, and revise Metro Therapy’s tuition reimbursement rates, as appropriate. Work with Metro Therapy …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/metro-therapy-inc-compliance-reimbursable-cost-manualXII.7.B Voucher Denials – XII. Expenditures
… and Document Preparation: Payment rejections can occur for various reasons, including at the agency’s request. The Bureau has established codes for the most common reasons payments are rejected. See the … ID, rejection reason code and rejection code description. For information on reprocessing a voucher after it has been …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii7b-voucher-denialsVII.10.B Establishing and Increasing a Cash Advance – VII. State Revenues and Appropriated Loan Receivables
… employees of State agencies. Request a Cash Advance Vendor ID (For New Advance Requests) After the bank account is … Vendor Management Unit to request a cash advance vendor ID as explained in Chapter X, Section 6.A – Requesting a Special Use Vendor ID of this Guide. Submit AP Voucher (For a New Advance or …
https://www.osc.ny.gov/state-agencies/gfo/chapter-vii/vii10b-establishing-and-increasing-cash-advanceState Comptroller DiNapoli Releases Audits
… eligible for coverage by Medicare. Homes and Community Renewal – Division of Housing and Community Renewal (DHCR): Administration of Mitchell-Lama Waiting Lists … implemented one recommendation. New York State Health Insurance Program: CVS Health – Accuracy of Drug Rebate …
https://www.osc.ny.gov/press/releases/2021/03/state-comptroller-dinapoli-releases-auditsSUNY Bulletin No. SU-269
… Confidential SUNY 68 Lifeguard UUP Background In 2016, the Governor signed into law a comprehensive Paid … any waivers received from the employee and retain the form in the employee’s record. (The waiver form and special UUP and SUNY MC instructions can be found at …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-university-new-york/su-269-new-york-state-paid-family-leave-program-united-universityState Comptroller DiNapoli Releases Audits
… identified areas for improvement. New York State Health Insurance Program: UnitedHealthcare: Reasonable and Customary … effect on the date of the service. New York State Health Insurance Program: Empire BlueCross: Improper Payments for … systems used by NFTA on 66 devices. Homes and Community Renewal: Office of Rent Administration (ORA): Collection of …
https://www.osc.ny.gov/press/releases/2019/12/state-comptroller-dinapoli-releases-audits-0XIII.4.A Employee Travel Card Reconciliation – XIII. Employee Expense Reimbursement
… Owed to the State by an Employee - Using an Employee Check of this Chapter. Allowable Circumstances for Delays in … but the traveler has already purchased the plane or train ticket, the traveler has up to one year from the purchase date to use the ticket. In these instances, travelers should not reconcile …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xiii/xiii4a-employee-travel-card-reconciliation