Search
Medicaid Program – Improper Managed Care Payments for Misclassified Patient Discharges
… codes on inpatient claims. The audit covered the period from January 1, 2016 through December 31, 2021. About the … to reimburse hospitals for inpatient medical care. When a hospital bills an MCO for an inpatient stay, the hospital … payment than if the patient was simply discharged home from the hospital. Key Findings The audit identified 2,808 …
https://www.osc.ny.gov/state-agencies/audits/2022/08/19/medicaid-program-improper-managed-care-payments-misclassified-patient-dischargesCompliance With Special Education Regulations for the Provision of Services
… To determine if the New York City Department of Education (DOE) arranged for eligible students to be placed in special … students in special education. In New York City (NYC), the DOE is responsible for determining eligibility for and … such students. Specifically, the Regulations require that DOE arrange for the placement of eligible students in special …
https://www.osc.ny.gov/state-agencies/audits/2020/09/30/compliance-special-education-regulations-provision-servicesImproper Fee-for-Service Payments for Services Covered by Managed Care (Follow-Up)
… Fee-for-Service Payments for Services Covered by Managed Care (Report 2017-S-74 ). About the Program The Department of … providers using the fee-for-service (FFS) or managed care method. Under the FFS method, the Department, through … rendered to Medicaid recipients. Under the managed care method, the Department pays managed care plans a monthly …
https://www.osc.ny.gov/state-agencies/audits/2021/02/11/improper-fee-service-payments-services-covered-managed-care-followSelected Aspects of Collecting Outstanding Amounts Due for Parking Violations
… (DOF) identifies and collects fines and fees that are due for parking violations. This audit covered 262,765 cases … and mailing notices of violations, collecting the amounts due, and adjudicating summonses that are disputed by the … Division is responsible for collecting all amounts due from summonses that are in judgment (i.e., a vehicle …
https://www.osc.ny.gov/state-agencies/audits/2021/03/23/selected-aspects-collecting-outstanding-amounts-due-parking-violationsImproper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (Follow-Up)
… in our initial audit report, Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (Report … contained in our audit report Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition Report …
https://www.osc.ny.gov/state-agencies/audits/2020/09/02/improper-medicaid-payments-recipients-diagnosed-severe-malnutrition-followMedicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services (Follow-Up)
… made in our initial audit report, Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services … whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on APR-DRG (All … contained in our audit report Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-services-followEmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits
… by two subscriber plans under the New York State Dental Insurance Program. The audit covered the period from January … 2022. About the Program New York State provides dental insurance benefits to certain State employees and their … claims for services on behalf of the New York State Dental Insurance Program (Dental Program). Coordination of benefits …
https://www.osc.ny.gov/state-agencies/audits/2024/01/08/emblemhealth-plan-inc-overpayments-services-requiring-coordination-benefitsApplication Review and Site Permitting for Major Renewable Energy Projects
… Findings ORES was intended, in part, to reduce the time to site major renewable energy projects and bring them online … the feasibility of meeting Climate Act goals, all site permit process time frames should be accounted for, as … A realistic accounting of the total time it can take to site major renewable energy projects would provide important …
https://www.osc.ny.gov/state-agencies/audits/2024/04/24/application-review-and-site-permitting-major-renewable-energy-projectsCantalician Center for Learning – Compliance With the Reimbursable Cost Manual
… calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the … calculated adequately documented and allowable under the State Education Departments SED guidelines including the …
https://www.osc.ny.gov/state-agencies/audits/2023/01/26/cantalician-center-learning-compliance-reimbursable-cost-manualImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… by the Centers for Medicare & Medicaid Services (CMS), Medicaid pays Medicare premiums for individuals who … and process enrollment in the Buy-in Program. In addition, CMS automatically enrolls certain individuals. Medicaid … who were automatically added to the Buy-in Program by CMS with coverage beginning more than 2 years retroactively, …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followUse of Federal Funding for Election Technology and Security (Follow-Up)
… in our initial audit report, Use of Federal Funding for Election Technology and Security (Report 2020-S-18 ). About the Program The Board of Elections (BOE) is responsible for administering and enforcing election laws in the State. … in our initial audit report Use of Federal Funding for Election Technology and Security Report 2020S18 …
https://www.osc.ny.gov/state-agencies/audits/2023/06/22/use-federal-funding-election-technology-and-security-followBenefits Advisement Services for Individuals With Disabilities Seeking Employment (Follow-Up)
… and launched a benefits advisement system, Work Incentives Navigator and Reports (WINR), within the New York Employment …
https://www.osc.ny.gov/state-agencies/audits/2023/06/22/benefits-advisement-services-individuals-disabilities-seeking-employment-followQueens Centers for Progress – Compliance With the Reimbursable Cost Manual
… authorized by SED to provide a full-day Special Class program and a full-day Special Class in an Integrated Setting program to children with … $44,661 in affiliate dues expenses that were not necessary or directly related to the SED preschool cost-based programs; …
https://www.osc.ny.gov/state-agencies/audits/2023/08/10/queens-centers-progress-compliance-reimbursable-cost-manualUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… To determine whether UnitedHealthcare Insurance Company of New York appropriately reimbursed physician-administered … January 2017 through December 2021. About the Program The New York State Health Insurance Program (NYSHIP), … contracts with UnitedHealthcare Insurance Company of New York (United) to administer the Medical/Surgical Program …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsMedicaid Program – Improper Medicaid Payments for Recipients in Hospice Care
… to the terminal illness. Hospice can be provided in the home or in an inpatient setting and includes nursing and physician services, medical social services, … non-hospice providers for services, such as private duty nursing, that were not allowed in combination with the daily …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-improper-medicaid-payments-recipients-hospice-careVillage of Castile – Water Billing for Letchworth State Park (2021M-1)
… since June 2017. As a result, they overbilled State Parks by $7,577. Charged $12,000 in late fees that were not authorized by the contract or contract amendment. Key Recommendations … amendment. Stop charging late fees that are not authorized by the contract or contract amendment. Village officials …
https://www.osc.ny.gov/local-government/audits/village/2021/05/28/village-castile-water-billing-letchworth-state-park-2021m-1University Preparatory Charter School for Young Men - Payroll (2023M-123)
Determine whether University Preparatory Charter School for Young Men School officials accurately compensated employees
https://www.osc.ny.gov/local-government/audits/charter-school/2023/12/01/university-preparatory-charter-school-young-men-payroll-2023m-123Albany Leadership Charter School for Girls – Cash Collections (2022M-165)
… 91 and over 200 days after they were received. Monitor State aid payments to ensure all available revenue was received, recorded accurately and deposited timely . State aid checks totaling $41,167 were not accounted for or … collections lists and remittances to bank deposits. Ensure State aid payments are properly accounted for and deposited …
https://www.osc.ny.gov/local-government/audits/charter-school/2023/02/03/albany-leadership-charter-school-girls-cash-collections-2022m-165Brighter Choice Charter School for Girls – Non-Payroll Disbursements (2023M-72)
… other designated official did not review cancelled check images to ensure only approved disbursements were made. The … to be signed by the Principal. Review cancelled check images to ensure only authorized disbursements are made. …
https://www.osc.ny.gov/local-government/audits/charter-school/2023/09/22/brighter-choice-charter-school-girls-non-payroll-disbursements-2023m-72Model Code of Ethics for Local Governments - Frequently Asked Questions
… meet its own circumstances. However, pursuant to General Municipal Law Section 806(1)(a), counties, cities, towns, … a county and must, pursuant to Section 806 of the General Municipal Law, adopt their own code of ethics. Any other "municipality" as defined by the General Municipal Law is authorized, but not required, to adopt a …
https://www.osc.ny.gov/local-government/publications/model-code-ethics-local-governments-frequently-asked-questions