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Selected Aspects of Discretionary Spending
… to expedite the completion of the $700 million master plan for the State University of New York (SUNY). This master plan … corporation whose sole mission was to act as an agent for SUNY to design, construct, acquire and improve State … To accomplish its mission, the Fund incurs direct costs for specific program purposes and it incurs indirect or …
https://www.osc.ny.gov/state-agencies/audits/2014/09/19/selected-aspects-discretionary-spendingService Diversions for Maintenance and Capital Projects
… diversions. Our audit covered the period January 1, 2009 through August 16, 2011. Background The LIRR is a constituent … trains are diverted from their regular route so workers can safely access the tracks. Diversions should be scheduled … of the 15 elements we sampled required 691 outage days, but there was no support for how this was determined. In …
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
… Purpose To determine whether the Department of Health's eMedNY system processes Medicaid claims for ancillary … Medicaid claims for ancillary services are processed by eMedNY, the Department's automated claims processing and … are subject to various edits - automated controls within eMedNY designed to pay Medicaid claims in accordance with the …
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
… were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in … the providers. The audit covered the period April 1, 2015 through September 30, 2015. Background The Department of … Department terminated 26 of the providers we identified, but the status of five other providers was still under review …
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
… The audit covered expenses reported on Elmcrest’s CFR for the fiscal year ended June 30, 2014. Background Elmcrest is a not-for-profit organization located in Syracuse, New York that … the ages of three and five years. Elmcrest is reimbursed for these services through rates set by SED. These …
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)
… extent of implementation of the recommendation included in our initial audit report, Monitoring and Administration of … aggravated assault, forcible rape, murder, and robbery – in the State, excluding New York City. In previous years, some GIVE contracts included confidential …
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
… Objective To determine whether Medicaid overpayments for pharmacy services on behalf of managed care recipients … pays managed care organizations (MCOs) a monthly premium for each enrolled recipient, and in turn, the MCOs are required to pay for the Medicaid services their recipients require, which …
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)
… Objective To determine the extent of implementation of the recommendations in our initial audit report, Vacancies at the Clinton Towers Mitchell-Lama Housing Development … To determine the extent of implementation of the recommendations in our initial audit report Vacancies at …
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)
… review the remaining $115 million in premiums and recover all overpayments, and strengthen controls to prevent the …
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)
… with Executive Order 95 (EO 95), including providing, in a timely manner, publishable State data to the Office of … publishable State data and make such data freely available in accessible formats for public use. As of January 2020, … sets to publish on Open Data (most recent data was added in 2016), and OGS has not consistently updated data already …
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.
… for further review by an analyst. However, OMH generally does not perform detailed audits or field reviews of … on providers’ funding is somewhat reduced. Still, OMH does use the CFR data for informational and analytical …
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)
… with Executive Order 95 (EO 95), including providing, in a timely manner, publishable State data to the Office of … publishable State data and make such data freely available in accessible formats for public use. As of July 2020, there … data to post on Open Data (most recent data was added in 2015). We found the data Parks has posted to Open Data to …
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 … the Department of Health and Human Services in exchange for state Medicaid coverage of most of the manufacturer’s … Manufacturers then pay states rebates on those drugs for which Medicaid payments were made. Covered outpatient …
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
… through June 2023. About the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of … disabilities. Civil Service maintains eligibility and enrollment records for NYSHIP members, which include Medicare …
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
… were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to providers. The audit covered the … 2022, eMedNY processed over 224 million claims, resulting in payments to providers of nearly $38 billion. The claims …
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
… private providers throughout Queens County. OASAS also has a toll-free HOPEline, which provides callers with information … study to identify the number or location of individuals in need of problem gambling treatment services since 2006, even though four commercial casinos opened in New York State in 2013. Therefore, we could not determine …
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 … is reimbursed for preschool special education services through rates set by SED. The reimbursement rates are based …
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)
… Purpose To determine the extent of implementation of the four recommendations included in our initial audit report, Monitoring of Not-for-Profit Cemeteries for Fiscal Stability and … To determine the extent of implementation of the four recommendations included in our …
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)
… conduct investigations to determine compliance. The Law does not preclude nurses from volunteering to work additional hours and does not apply in situations such as health care disasters or …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-follow