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Medicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
… Purpose To determine whether the Department of Health established adequate controls to prevent duplicate … services using the APG payment methodology. The Department of Health (Department) adopted the APG methodology in an … are reimbursed based on patient condition and complexity of service. The Department phased in the APG methodology …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-ambulatory-patient-groups-payments-duplicate-claims-and-services-excessAssessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… and nonoccupational disabilities and sickness. Coverage for these benefits, with limited exception, is to be provided by their employers. The Board is also responsible for tracking its costs to administer the Workers’ … employee payroll expenses and are allocated appropriately for future assessments. Other Related Audits/Reports of …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Medicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… Objective To determine whether Medicaid overpayments for pharmacy services on behalf of managed care recipients who … Medicaid services their recipients require, which includes pharmacy services. Many recipients have other third-party … audit period, HMS’ third-party liability recoveries on MCO pharmacy payments totaled about $118 million. Key Findings We …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… Medicaid overpayments for inpatient services on behalf of managed care recipients who had third-party health … 2017 through August 2021. About the Program The Department of Health (Department) administers New York’s Medicaid program. Many of the State’s Medicaid recipients receive their services …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsIFB #0001 – Disaster Recovery Services for the Printing, Sorting and Mailing of Payroll Checks and Tax Forms
… Invitation for Bids Issued by the Office of the State Comptroller … Comptroller (“OSC”) is seeking disaster recovery services for the printing, sorting and mailing of payroll checks and … other information as it becomes available, is available for download through the following links: Invitation for …
https://www.osc.ny.gov/procurement/ifb0001Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up) (2022-F-31) 30-Day Response
To assess the extent of implementation of the nine recommendations included in our initial audit report, Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Report 2018-S-71).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22f31-response.pdfImproper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (Follow-Up) (2024-F-26)
To determine the extent of implementation of the five recommendations included in our audit report, Medicaid Program: Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (Report 2022-S-16).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-24f26.pdfServices to Workers Under the Worker Adjustment and Retraining Notification Act (Follow-Up) (2024-F-22)
To assess the extent of implementation of the four recommendations included in our initial audit report, Services to Workers Under the Worker Adjustment and Retraining Notification Act (Report 2022-S-11).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-24f22-response.pdfServices to Workers Under the Worker Adjustment and Retraining Notification Act (Follow-Up) (2024-F-22)
To assess the extent of implementation of the four recommendations included in our initial audit report, Services to Workers Under the Worker Adjustment and Retraining Notification Act (Report 2022-S-11).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-24f22.pdfProtecting our Elderly Population: Select Elder Care Program Audits (2021-2023)
New York State has the fourth-largest population of older adults in the United States, with over 3.3 million New Yorkers age 65 and older (about 17 percent of the population).
https://www.osc.ny.gov/files/reports/pdf/select-elder-care-program-audits-2021-2023.pdfEco News - April 2024
Over the last year, my office has conducted audits of the State’s air quality monitoring, the MTA’s preparedness for extreme weather events, the security of our water supply and more.
https://www.osc.ny.gov/files/press/pdf/eco-newsletter-2024.pdfImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up) (2022-F-31)
To assess the extent of implementation of the nine recommendations included in our initial audit report, Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Report 2018-S-71).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22f31.pdfEfforts to Collect Tolls and Fees Using License Plate Images and Law Firms (Follow-Up) (2021-F-15) 30-Day Response
To determine the extent of implementation of the eight recommendations included in our initial audit report, Efforts to Collect Tolls and Fees Using Images and Law Firms (Report 2017-S-70).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-21f15-response.pdfImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up) (2021-F-4) 30-Day Response
To determine the extent of implementation of the three recommendations included in our initial audit report, Improper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Report 2018-S-65).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-21f4-response.pdfEfforts to Collect Tolls and Fees Using License Plate Images and Law Firms (Follow-Up) (2021-F-15)
To determine the extent of implementation of the eight recommendations included in our initial audit report, Efforts to Collect Tolls and Fees Using Images and Law Firms (Report 2017-S-70).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-21f15.pdfImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up) (2021-F-4)
To determine the extent of implementation of the three recommendations included in our initial audit report, Improper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Report 2018-S-65).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-21f4.pdfMedicaid Cap Legislation
A new law was enacted (Chapter 58 of the Laws of 2005) to “cap” county Medicaid costs at calendar 2005 levels and limit growth rates to 3.5 percent in 2006 and
https://www.osc.ny.gov/files/local-government/publications/pdf/medicaidcap_1.pdfMotor Vehicle Theft and Insurance Fraud Prevention Program (2022-M-2) 180-Day Response
To determine whether the Division of Criminal Justice Services (DCJS) has complied with Article 36-A of the State Executive Law for revenues received by and expenditures made from the Motor Vehicle Theft and Insurance Fraud Prevention Fund and from any other source for purposes of the Motor Vehicle
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2024-22m2-response.pdfIdentifying, Reporting, and Providing Services for Youth at Risk of Sexual Human Trafficking in New York City (2021-N-2) 180-Day Response
To determine if the New York City Administration for Children’s Services and the New York City Department of Youth and Community Development identify, report on, and provide services for victims of child sex trafficking and those at risk of child sex trafficking. The audit covered the period from Ja
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-21n2-response2.pdfHandicapped Children’s Association of Southern New York, Inc. – Compliance With the Reimbursable Cost Manual (2022-S-49)
To determine whether the costs reported by Handicapped Children’s Association of Southern New York, Inc. on its Consolidated Fiscal Reports were reasonable, necessary, directly related to the special education program, and sufficiently documented pursuant to the State Education Department's ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2024-22s49.pdf