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CVS Health – Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… audit report, CVS Health: Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil … prescription drug coverage under Empire Plan Medicare Rx, a Medicare Part D Prescription Drug Plan with expanded … received about $1.2 billion in Empire Plan Medicare Rx rebates. The objective of our initial audit, issued on …
https://www.osc.ny.gov/state-agencies/audits/2025/08/27/cvs-health-accuracy-empire-plan-medicare-rx-drug-rebate-revenue-remitted-department-civilOversight of Juvenile Justice Facilities (Follow-Up)
… included in our initial audit report, Oversight of Juvenile Justice Facilities (Report 2022-S-13 ). About the … Toward this end, OCFS, through its Division of Juvenile Justice and Opportunities for Youth (DJJOY), is … the operation and oversight of nine State-run residential juvenile justice facilities that serve court-placed youth. …
https://www.osc.ny.gov/state-agencies/audits/2026/02/12/oversight-juvenile-justice-facilities-followDiNapoli and Ulster Co. DA Nneji: Owner of Ulster Co. Medical Transportation Company Pleads Guilty to Stealing $1.1 Million in Medicaid Fraud Scheme
… 40, the owner of MAK Limo, pleaded guilty in Ulster County Court before Judge Brian Rounds. He faces up to 15 years in … in here and working collaboratively with us, permitting me to designate one of his attorneys as assistant district … the toll-free Fraud Hotline at 1-888-672-4555, by filing a complaint online at https://www.osc.ny.gov/investigations , …
https://www.osc.ny.gov/press/releases/2026/03/dinapoli-and-ulster-co-da-nneji-owner-ulster-co-medical-transportation-company-pleads-guilty-stealingSelected Management and Operations Practices (Follow-Up)
… of New York signed into law the ReCharge New York (RNY) power program as part of Chapter 60 (part CC) of the Laws of 2011 (Law). RNY power is to be allocated to businesses and not-for-profits … makes available 910 megawatts (MW) of economic development power, 50 percent to be purchased by the New York Power …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/selected-management-and-operations-practices-followMedicaid Program – Medicaid Drug Rebate Program Under Managed Care
… 2014. Background In 1990, Congress created the Medicaid Drug Rebate Program (Rebate Program) to reduce state and … been able to recover a portion of Medicaid prescription drug costs by requesting rebates from drug manufacturers. The Affordable Care Act, enacted in 2010, …
https://www.osc.ny.gov/state-agencies/audits/2015/02/18/medicaid-program-medicaid-drug-rebate-program-under-managed-careUnited Community Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by United Community Services, Inc. (United) on its Consolidated Fiscal Reports (CFRs) were … Manual (Manual). The audit covered expenses claimed on United’s CFRs for the three fiscal years ended June 30, 2014. … To determine whether the costs reported by United Community Services Inc United on its Consolidated …
https://www.osc.ny.gov/state-agencies/audits/2015/12/30/united-community-services-inc-compliance-reimbursable-cost-manualContract Participation of Minority- and Women-Owned Business Enterprises
… contract participation goals for minority- and women-owned business enterprises and accurately reported program results to the Department of Economic Development. The audit covered the period of April 1, 2011 … to promote the participation of minority- and women-owned business enterprises (MWBEs) in their contracts. State …
https://www.osc.ny.gov/state-agencies/audits/2015/07/08/contract-participation-minority-and-women-owned-business-enterprisesUnited HealthCare – Empire Plan Drug Rebates
… for rebates, discounts, and other considerations and pass 100 percent of the value of the agreements on to the …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/united-healthcare-empire-plan-drug-rebatesCompliance With Payment Card Industry Standards
… (System Administration) acts as the governance arm of the SUNY system, and provides the various SUNY schools …
https://www.osc.ny.gov/state-agencies/audits/2016/06/08/compliance-payment-card-industry-standardsUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… Purpose To determine if Davis Ethical Pharmacy inappropriately billed United HealthCare for … United for all properly adjudicated claims. Davis Ethical Pharmacy (Davis Ethical) is an independently owned pharmacy located in Rockville Centre, New York. For the … To determine if Davis Ethical Pharmacy inappropriately billed United HealthCare for …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyEmpire BlueCross BlueShield – Payments to John T. Mather Memorial Hospital (Follow-Up)
… were implemented. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Empire BlueCross Blue Shield - Payments to …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/empire-bluecross-blueshield-payments-john-t-mather-memorial-hospital-followMedicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… Purpose To determine whether Medicaid overpaid hospitals by reimbursing for higher levels of medical care than those actually provided to patients. The audit covers the period April 1, 2005 … To determine whether Medicaid overpaid hospitals by reimbursing for higher levels of medical care than those actually …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissionsDual Employment
… Department of Corrections and Community Supervision (DOCCS) employees who are dually employed at multiple … period April 1, 2010 through February 6, 2013. Background DOCCS is responsible for the confinement and habilitation of … 60 facilities across the State. As of September 1, 2012, DOCCS had 29,796 employees. To ensure adequate staffing at …
https://www.osc.ny.gov/state-agencies/audits/2013/12/19/dual-employment-2Corcraft's Textile Procurement Practices
… offenders in the industry programs it operates at 11 correctional facilities. Sales were about $49 million for … personnel issue an Invitation for Bid (IFB) with product specifications, followed by bid evaluation, sample testing, … procurement of textiles. This includes providing input on specifications, evaluating bid submissions, and approving the …
https://www.osc.ny.gov/state-agencies/audits/2014/05/16/corcrafts-textile-procurement-practicesCriminal History Background Checks of Unlicensed Health Care Employees
… oversees and monitors efforts by Nursing Homes, Adult Care Facilities (ACF), and Home Health Care (HHC) … effectively oversees and monitors efforts by Nursing Homes Adult Care Facilities and Home Health Care providers to …
https://www.osc.ny.gov/state-agencies/audits/2017/06/08/criminal-history-background-checks-unlicensed-health-care-employeesAccounts Payable Advisory No. 29
… Guide to Financial Operations: Chapter XII, Section 4.B - Certification of Vouchers Chapter XII, Section 4.D - Certification of Internal Controls over the Payment Process … controls over the payment process as a basis for that certification. This certification requirement is separate and …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/29-internal-controls-certificationCanarsie Childhood Center, Inc. – Compliance With the Reimbursable Cost Manual
… preschool multidisciplinary evaluations and provides 1:1 Aide services to children enrolled in the cost-based program. … that were not proportionately similar to other classes or groups of employees. $24,772 in unsupported other than … including $433 in salary and $71 in fringe benefits for a Teacher Assistant. Key Recommendations To SED: Review the …
https://www.osc.ny.gov/state-agencies/audits/2022/02/01/canarsie-childhood-center-inc-compliance-reimbursable-cost-manualPurchasing and Procurement Practices
… goods and services competitively and in accordance with its policies and procedures. Our audit covered the … a NYRA employee to select his company to do business with NYRA and receive payments totaling almost $200,000. We … goods and services competitively and in accordance with its policies and procedures …
https://www.osc.ny.gov/state-agencies/audits/2022/03/16/purchasing-and-procurement-practicesMedicaid Program – Improper Overlapping Medicaid and Essential Plan Enrollments
… and Essential Plan enrollments determined by NY State of Health were accurately reflected in eMedNY when individuals … State Medicaid program, administered by the Department of Health (Department), provides a wide range of health care services to individuals who are economically …
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)
… of TMH and TMH practitioners. OMH also issued a blanket attestation for providers to complete that wished to offer …
https://www.osc.ny.gov/state-agencies/audits/2022/12/06/oversight-telemental-health-services-follow