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Selected Aspects of Discretionary Spending
… its mission, the Fund incurs direct costs for specific program purposes and it incurs indirect or “discretionary … documentation. Other Related Audit/Report of Interest Battery Park City Authority: Selected Aspects of …
https://www.osc.ny.gov/state-agencies/audits/2014/09/19/selected-aspects-discretionary-spendingService Diversions for Maintenance and Capital Projects
… effectively managed service diversions due to scheduled track maintenance and capital projects and (2) adequately … takes place when LIRR must close all or a part of a track line for capital projects or maintenance. When service … review and approve significant changes in the Outage Plan. Track the actual costs of service diversion elements for …
https://www.osc.ny.gov/state-agencies/audits/2014/03/18/service-diversions-maintenance-and-capital-projectsMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… services provided in the home, medical offices, clinics, and other freestanding sites. They can be classified into three general categories: diagnostic, therapeutic, and custodial. For example, laboratory, physical therapy, and … for review. Medicaid reimbursement rates for inpatient hospital claims include the costs of most medical care …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid Program – Medicaid Claims Processing Activity April 1, 2015 Through September 30, 2015
… through New York State of Health, the Department’s online marketplace for health insurance; $1,052,058 in overpayments …
https://www.osc.ny.gov/state-agencies/audits/2016/08/09/medicaid-program-medicaid-claims-processing-activity-april-1-2015-through-september-30-2015Elmcrest Children’s Center, Inc. – Compliance With the Reimbursable Cost Manual
… for these services through rates set by SED. These reimbursement rates are based on financial information, … reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM … costs reported on Elmcrest’s CFR and to Elmcrest’s tuition reimbursement rates. Remind Elmcrest officials of the …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/elmcrest-childrens-center-inc-compliance-reimbursable-cost-manualMonitoring and Administration of Public Protection Grant Programs (Follow-Up)
… administers 11 State and federal grant programs aimed at crime prevention and control. Among these public … – such as aggravated assault, forcible rape, murder, and robbery – in the State, excluding New York City. In previous …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/monitoring-and-administration-public-protection-grant-programs-followMedicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… To determine whether Medicaid overpayments for pharmacy services on behalf of managed care recipients who had … Many of the State’s Medicaid recipients receive their services through managed care, where the Department pays … and in turn, the MCOs are required to pay for the Medicaid services their recipients require, which includes pharmacy …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsMedicaid Program – Improper Supplemental Maternity Capitation Payments to Managed Care Organizations
… payments. The Department’s eMedNY claims processing system does not have access to maternity encounter data to verify … to identify and recoup inappropriate SMCPs. However, OMIG does not perform these audits in a timely manner, and its …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-supplemental-maternity-capitation-payments-managed-careVacancies at the Clinton Towers Mitchell-Lama Housing Development (Follow-Up)
… recommendations in our initial audit report, Vacancies at the Clinton Towers Mitchell-Lama Housing Development … on December 8, 2017, examined whether vacant housing units at the Clinton Towers Mitchell-Lama development were being … over 10,000 applicants on the waiting lists for apartments at Clinton Towers. The initial audit found that HPD was not …
https://www.osc.ny.gov/state-agencies/audits/2020/01/30/vacancies-clinton-towers-mitchell-lama-housing-development-followInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations made in our initial audit report, … was eliminated effective January 1, 2015 and the majority of FHP enrollees transitioned to the Medicaid program. … To determine the extent of implementation of the five recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andCompliance With Executive Order 95 (Open Data)
… to State agencies, including managing and leasing real property; designing and building facilities; and contracting …
https://www.osc.ny.gov/state-agencies/audits/2020/04/08/compliance-executive-order-95-open-dataOversight of Provider Consolidated Fiscal Reports – Independent Living, Inc.
… by providers such as Independent Living, Inc. (ILI) on their Consolidated Fiscal Reports (CFRs) are allowable, … requirements. The audit covered the information reported on ILI’s CFR for the period January 1, 2018 through December … audits, as needed, including reviewing costs reported on the CFR for compliance with appendices of the CFR Manual. …
https://www.osc.ny.gov/state-agencies/audits/2020/09/02/oversight-provider-consolidated-fiscal-reports-independent-living-incCompliance With Executive Order 95 (Open Data)
… Objectives To determine whether the Office of Parks, Recreation and Historic Preservation (Parks) is complying with Executive Order 95 (EO 95), … on subjects such as health, business, public safety, parks and recreation, labor, and transportation. EO 95, … To determine whether the Office of Parks Recreation and Historic Preservation Parks is complying …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/compliance-executive-order-95-open-dataMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement
To determine whether Medicaid inappropriately paid for drugs from manufacturers that did not enter into a national drug rebate agreement NDRA
https://www.osc.ny.gov/state-agencies/audits/2024/02/23/medicaid-program-improper-payments-drugs-without-federal-drug-rebate-agreementAnthem Blue Cross – Coordination of Benefits With Medicare
… Objective To determine whether Anthem Blue Cross coordinated benefits to properly pay claims for NYSHIP Empire Plan members with … To determine whether Anthem Blue Cross coordinated benefits to properly pay claims for NYSHIP Empire Plan members with …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareMedicaid Program – Claims Processing Activity April 1, 2022 Through September 30, 2022
… which averaged about 8.6 million claims and nearly $1.5 billion in payments to providers. Key Findings The audit … million in improper Medicaid payments, as follows: $10.2 million was paid for managed care premiums on behalf of … as the primary payer instead of another insurer; $2.1 million was paid for fee-for-service inpatient claims that …
https://www.osc.ny.gov/state-agencies/audits/2023/05/11/medicaid-program-claims-processing-activity-april-1-2022-through-september-30-2022Problem Gambling Treatment Program
… and Substance Abuse Services: Contracted Programs With Puerto Rican Organization to Motivate, Enlighten and Serve …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/problem-gambling-treatment-programLeake and Watts Services, Inc. – Compliance With the Reimbursable Cost Manual
… ended June 30, 2015. Background Leake and Watts (which, in 2018, changed its name to Rising Ground) is an SED-approved, not-for-profit special education provider located in Westchester County, New York. Leake and … provides preschool special education services to children with learning disabilities who are between three and five …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/leake-and-watts-services-inc-compliance-reimbursable-cost-manualMonitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance (Follow-Up)
… and preservation of burial grounds for all not-for-profit cemetery corporations (cemeteries) in New York State. As … Law (Law), and under the supervision of the State’s Cemetery Board (Board), the Division works with cemetery officials on a wide range of issues, including the …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/monitoring-not-profit-cemeteries-fiscal-stability-and-adequate-facility-maintenance-followRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… compliance. The Law does not preclude nurses from volunteering to work additional hours and does not apply in …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-follow