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Empire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… district employees, and their dependents. The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. … Payments for hospital services are generally based on standard fee schedules that are negotiated between Empire and … (implants, drugs and blood) that are not covered by the standard fee schedules. Agreements with many of Empire’s …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial audit report, … made improper payments totaling $94,460 to Davis Ethical Pharmacy. Based on information obtained from the prescribers … Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11) United HealthCare Insurance Program: …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followContracts for Personal and Miscellaneous Services (Follow-Up)
… contracts were still needed, or whether they could be suspended or scaled-back to help reduce costs. We also found …
https://www.osc.ny.gov/state-agencies/audits/2015/01/06/contracts-personal-and-miscellaneous-services-followHousing Preferences for Veterans (Follow-Up)
… by housing companies and lax enforcement by the New York City Department of Housing Preservation and Development (NYC … found two housing companies in Manhattan (Hamilton House and Clinton Towers) filled vacant apartments with non-veterans even though veterans had been …
https://www.osc.ny.gov/state-agencies/audits/2015/01/29/housing-preferences-veterans-followTravel Plaza Revenues and Capital Improvements (Follow-Up)
… included in our initial audit report, Travel Plaza Revenues and Capital Improvements (Report 2008-S-103). … included in our initial audit report Travel Plaza Revenues and Capital Improvements …
https://www.osc.ny.gov/state-agencies/audits/2014/08/14/travel-plaza-revenues-and-capital-improvements-followInspecting Highway Bridges and Repairing Defects (Follow-Up)
… of implementation of the three recommendations included in our initial audit report, Inspecting Highway Bridges and Repairing Defects (Report 2012-S-33). Background In our initial audit report, which was issued on Report April … NYSTA implemented the three recommendations we made in our initial report. Key Recommendations None Other Related …
https://www.osc.ny.gov/state-agencies/audits/2014/06/25/inspecting-highway-bridges-and-repairing-defects-followContracts for Personal and Miscellaneous Services (Follow-Up)
… Purpose To determine the extent of implementation of the five … (Port Authority) generally did not have documentation to justify the need for new or renewed contracts for personal … addition, the Port Authority did not provide documentation to support that it periodically reassessed all of its …
https://www.osc.ny.gov/state-agencies/audits/2014/01/07/contracts-personal-and-miscellaneous-services-followMedicaid Claims Processing Activity October 1, 2008 Through March 31, 2009 (Follow-Up)
… from a reimbursement rate that was incorrectly updated on a rate file loaded onto the eMedNY system. The remaining … issuance of the follow-up review to provide information on any actions that are planned to address the unresolved …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/medicaid-claims-processing-activity-october-1-2008-through-march-31-2009-followNew York Psychiatric Center – Controls Over State Resources (Follow-Up)
… included in our initial audit report, New York State Psychiatric Institute - Controls Over State Resources … (Report 2008-S-145). Background The New York State Psychiatric Institute (Institute), established in 1895, is …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/new-york-psychiatric-center-controls-over-state-resources-followRebates and Discounts on Physician-Administered Drugs (Follow-Up)
… report, Rebates and Discounts on Physician-Administered Drugs (2010-S-72). Background Physician-administered drugs, such as chemotherapy, are administered to patients by … office setting. To reduce Medicaid costs for prescription drugs, the federal government established the Medicaid Drug …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/rebates-and-discounts-physician-administered-drugs-followOverpayments for Medicare Part C Coinsurance Charges (Follow-Up)
… for excessive amounts of coinsurance on 497 claims for clinic services. Because of the excessive claims, Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2013/12/12/overpayments-medicare-part-c-coinsurance-charges-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… for the Period April 1, 2011 Through June 30, 2011 (2011-S-42). Background The New York State Health Insurance Program … coverage to active and retired State, participating local government and school district employees and their … for the Period April 1, 2011 Through June 30, 2011 (2011-S-42) …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughArrochar Meats, Inc.
… Arrochar Meats purchased 13,960 gallons of fuel from Burke Heat at an average of $3.71 per gallon, and 5,000 gallons of … to DMNA for $4.99 per gallon and had People’s Oil or Burke Heat deliver the fuel directly to DMNA’s facilities. As a … items such as fuel during times of disaster. Ensure Burke Heat is aware that the outstanding balance associated with …
https://www.osc.ny.gov/state-agencies/audits/2015/07/29/arrochar-meats-incCosts to Administer the Insurance Division Operations for the Three Fiscal Years Ended March 31, 2012
… accurately, pursuant to Section 332, Article 3 of the Insurance Law. Our audit covered the period April 1, 2009 … regulating all insurance activities in New York, including life, property/casualty and health insurance. Insurance regulation includes ensuring that …
https://www.osc.ny.gov/state-agencies/audits/2013/10/09/costs-administer-insurance-division-operations-three-fiscal-years-ended-march-31-2012Contract Advisory No. 29
… Subject : Electronic Documents Submission System (EDSS) Host Agency … of the State Comptroller's Bureau of Contracts (BOC) Electronic Documents Submission System (EDSS) has launched a … submit a New York State Office of the State Comptroller Electronic Documents Submission System (EDSS) Hosting Access …
https://www.osc.ny.gov/state-agencies/advisories/contract-advisory/29-electronic-documents-submission-system-edss-host-agencyFacility Planning Bureau Project Review (Follow-Up)
… 6 months or longer to finalize its approval for 2,764 (43.8%) of the 6,315 projects analyzed. The Bureau also lacked …
https://www.osc.ny.gov/state-agencies/audits/2022/01/05/facility-planning-bureau-project-review-followSelected Performance Measures (Follow-Up)
… Objective To determine the extent of implementation of the seven recommendations included in our initial audit … New York State Legislature in 1965. There are six agencies of the MTA: Bridges and Tunnels, MTA Construction and … To determine the extent of implementation of the seven recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2022/04/08/selected-performance-measures-followHeat and Hot Water Complaints (Follow-Up)
… of the eight recommendations in our initial audit report, Heat and Hot Water Complaints (Report 2019-N-3 ). About the … and well-maintained, which includes providing adequate heat and hot water (HHW). In accordance with the Code, … building owners must supply their tenants with adequate heat from October 1 to May 31, the “heat season,” which …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/heat-and-hot-water-complaints-followHuman Resource Practices (Follow-Up)
… information provided by Upstate, it serves approximately 1.8 million people and is Central New York’s largest … officials, each year, Upstate’s Human Resource Department (HR) receives over 30,000 employment applications and … 2015 through June 24, 2019. Overall, we found insufficient HR monitoring and oversight, as well as inadequate or poorly …
https://www.osc.ny.gov/state-agencies/audits/2021/07/16/human-resource-practices-followUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Follow-Up)
… Objective To assess the extent of implementation of the two recommendations included in our initial audit report, Out-of-Network Providers Upcoding Selected Evaluation and … To assess the extent of implementation of the two recommendations included in our initial audit …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-services