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Improper Episodic Payments to Home Health Providers (Follow-Up)
… (Department) implemented the new Episodic Payment System (EPS) to reimburse Certified Home Health Agencies (CHHA) for … care services provided to Medicaid recipients in the home. EPS is based on 60-day episodes of care. CHHAs can be paid … Medicaid program made improper payments to CHHAs under the EPS. The audit covered the period from May 1, 2012 through …
https://www.osc.ny.gov/state-agencies/audits/2018/05/04/improper-episodic-payments-home-health-providers-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-careMTA Headquarters and MTA Capital Construction – Travel and Entertainment Expenses
… travel to verify that lodging rates are consistent with GSA and DOS rate limits. Also, advise such supervisors to ensure that unsuccessful efforts to obtain GSA or DOS rates are adequately documented. Establish controls to …
https://www.osc.ny.gov/state-agencies/audits/2015/02/02/mta-headquarters-and-mta-capital-construction-travel-and-entertainment-expensesTrash Can Free Stations Pilot Program
… reduce refuse in the City’s subway system by removing the garbage cans from the platforms at selected stations. SEO’s objective … solve the problem “of poor customer experience of exposed garbage bags in stations and eliminate the accompanying …
https://www.osc.ny.gov/state-agencies/audits/2015/09/22/trash-can-free-stations-pilot-programMedicaid Program – Excessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans
… from MMC and HARP and moved to Medicaid fee-for-service (FFS) because the cost of the managed care premiums generally … of deductibles and coinsurance that Medicaid would pay on FFS claims for dual-eligibles. In response to the coronavirus … as long as minimum essential coverage (e.g., Medicaid FFS) was maintained. Key Findings We identified over $194.1 …
https://www.osc.ny.gov/state-agencies/audits/2022/10/31/medicaid-program-excessive-premium-payments-dual-eligible-recipients-enrolled-mainstreamImproper Fee-for-Service Payments for Services Covered by Managed Care (Follow-Up)
… Improper Fee-for-Service Payments for Services Covered by Managed Care (Report 2017-S-74 ). About the Program The … made improper FFS payments for certain services covered by Plans. The audit covered the period January 1, 2013 … FFS payments for services that should have been covered by the recipients’ Plans. We determined the majority of the …
https://www.osc.ny.gov/state-agencies/audits/2021/02/11/improper-fee-service-payments-services-covered-managed-care-followAdministration of Mitchell-Lama Waiting Lists (Follow-Up)
… of 269 State-supervised developments, with over 105,000 apartments, were built under the Program. In exchange for … out, they are no longer subject to DHCR supervision, and apartments do not need to be kept affordable for … non-compliance with key regulations, such as: applicants who were not selected from the AWL; developments not …
https://www.osc.ny.gov/state-agencies/audits/2021/01/19/administration-mitchell-lama-waiting-lists-followSelected Wage Investigation Procedures
… including conducting outreach to claimants about case status and recovered wages. Our audit covered the period … employer within 60 days of creating a wage investigation case in the Department’s tracking system (docketing), as … make initial contact with employers within 60 days of case docketing and fully document their actions. Make efforts …
https://www.osc.ny.gov/state-agencies/audits/2021/03/03/selected-wage-investigation-proceduresHousing Trust Fund Corporation – Oversight of the Residential Emergency Services to Offer Home Repairs to the Elderly Program
… Emergency Services to Offer Home Repairs to the Elderly (RESTORE) program in accordance with program goals … selecting LPAs and ensuring RESTORE program funds reach elderly residents from more counties and within the … Emergency Services to Offer Home Repairs to the Elderly RESTORE program …
https://www.osc.ny.gov/state-agencies/audits/2021/07/15/housing-trust-fund-corporation-oversight-residential-emergency-services-offer-home-repairsSelect Financial Management Practices at the Office of Transportation and Parking Operations
… revenue collection process for the Administration Parking Garage (Admin Garage) and Metered Parking IFRs. For example, we found 310 unaccounted-for tickets for the Admin Garage for the ten days in our sample. Key Recommendations …
https://www.osc.ny.gov/state-agencies/audits/2020/09/03/select-financial-management-practices-office-transportation-and-parking-operationsOversight of Managed Long-Term Care Member Eligibility (Follow-Up)
… plans, which provide long-term care services, such as home health care and nursing home care, for people who are chronically ill or disabled. For the year ended December 31, 2022, Medicaid paid …
https://www.osc.ny.gov/state-agencies/audits/2024/03/13/oversight-managed-long-term-care-member-eligibility-followMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… of managed care recipients who had third-party health insurance were appropriately recovered. The audit covered the … services. Many recipients have other third-party health insurance (TPHI) in addition to Medicaid (e.g., … million in inpatient claims where MCOs paid as the primary insurance despite recipients having TPHI inpatient coverage. …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsSUNY Maritime College Review of PCard Transactions and TCard Expenses
… and complied with Office of General Services (OGS) Citibank and Maritime Citibank-VISA PCard Guidelines and the … goods and services that are within the guidelines of New York State’s Procurement Card program. The cardholder’s …
https://www.osc.ny.gov/state-agencies/audits/2019/06/07/suny-maritime-college-review-pcard-transactions-and-tcard-expensesOversight of Campus Foundations (Follow-Up)
… $2.3 billion. Two foundations, Stony Brook Foundation, Inc. (SBF) and University at Buffalo Foundation, Inc. (UBF), controlled $1.2 billion, more than half of the … the foundations were required to have, such as the IRS Form 990 and the foundations’ policies and procedures for key …
https://www.osc.ny.gov/state-agencies/audits/2019/09/06/oversight-campus-foundations-followDevelopmental Disabilities Institute, Inc. – Compliance With the Reimbursable Cost Manual
… an SED-approved school-age special education program, an Early Intervention program funded through the Department of … of Interest State Education Department: Infant and Child Learning Center - The Research Foundation for the State University of …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/developmental-disabilities-institute-inc-compliance-reimbursable-cost-manualCity of Dunkirk – Budget Review (B24-1-10)
… [read complete report – pdf] Purpose The purpose of our budget review was to provide an independent evaluation of the City’s proposed budget for 2025. Background Chapter 5 6 of the Laws of 2024, Part DD … The purpose of our budget review was to provide an independent evaluation of the …
https://www.osc.ny.gov/local-government/audits/city/2024/11/27/city-dunkirk-budget-review-b24-1-10Adequacy of 2021 Budgets - Town of Niskayuna (S9-21-11)
… on the financial operations of local governments across New York State. Some local governments have seen little to no impact …
https://www.osc.ny.gov/local-government/audits/statewide-audit/2021/05/07/adequacy-2021-budgets-town-niskayuna-s9-21-11Monitoring Town Asphalt Road Projects (2012MS-7)
… audit was to determine whether towns adequately monitored road surfacing projects for the period January 1, 2011, to … requires vendors hired on a public work contract (such as road surfacing) to pay their employees on that contract the … Key Findings Towns can improve their monitoring of asphalt road surfacing projects to better ensure that asphalt …
https://www.osc.ny.gov/local-government/audits/statewide-audit/2013/04/05/monitoring-town-asphalt-road-projects-2012ms-7Oswego County – Court and Trust Funds (2022-C&T-5)
… money from foreclosures and contract disputes resulting in a mechanic’s lien (i.e., a security interest in property filed to ensure payment for contracted services … rendered on the property). These actions are recorded in the County Clerk’s (Clerk) office when payments are …
https://www.osc.ny.gov/local-government/audits/county/2022/11/23/oswego-county-court-and-trust-funds-2022-ct-5CUNY Bulletin No. CU-522
… on 12/15/15 receive $756.57. Hourly Staff Nurses who work 950 hours or more during the calendar year, January 1 through … receive $423.68. Hourly Staff Nurses who work less than 950 hours during the calendar year, January 1 through …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-522-2015-city-university-new-york-cuny-nurses-health-specialty