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State Agencies Bulletin No. 2346
… All agencies with appropriations due to lapse on June 30, 2025 are affected. Background: Appropriations allocated to … Effective Dates: Administration paychecks dated July 2, 2025 and Institution paychecks dated July 10, 2025 OSC Actions: OSC has provided a spreadsheet of all …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2346-updating-payserv-chartfield-strings-june-lapsing-eventsMedicaid Program – Claims Processing Activity April 1, 2024 Through September 30, 2024
… Objective To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … back to January 2022. About the Program The Department of Health (DOH) administers the State’s Medicaid program. … 249 million claims, resulting in payments to providers of nearly $50.6 billion. The claims are processed and paid in …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/medicaid-program-claims-processing-activity-april-1-2024-through-september-30-2024Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)
… of implementation of the three recommendations included in our initial audit report, Incorrect Payments by CVS … Findings Civil Service and CVS Caremark made some progress in addressing the issues identified in the initial audit, including reprocessing over $5 million …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-underAnthem Blue Cross – Coordination of Benefits With Medicare
… of Civil Service (Civil Service), is one of the nation’s largest public sector health insurance programs. NYSHIP … with Anthem Blue Cross (Anthem) to administer the Hospital Program of the Empire Plan. The Hospital Program … proper coordination of benefits did not occur. Anthem’s eligibility system was not always updated timely with …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareMedicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… in the Recipient Restriction Program received services from the appropriate providers. The audit covered the period from July 2018 through May 2023. About the Program DOH … their designated health care providers or via referral from those providers. Generally, claims for non-emergency …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientVendor Responsibility Review Process
… of the contract fully. Who determines responsibility It is the State contracting entity’s duty to evaluate the … information, see How to Conduct a Responsibility Review. What must be filed For each contract, the State contracting … see How to Make a Responsibility Determination. What happens after filing Our office will review the Vendor …
https://www.osc.ny.gov/state-vendors/vendrep/vendor-responsibility-review-processEmpire BlueCross – Overpayments for Physician-Administered Drugs (Follow-Up)
… coverage. Civil Service contracts with Anthem Blue Cross (Anthem), formerly Empire BlueCross, to administer the …
https://www.osc.ny.gov/state-agencies/audits/2025/06/04/empire-bluecross-overpayments-physician-administered-drugs-followMedicaid Program – Oversight of Managed Care Provider Networks
… (DOH) has provided adequate oversight of Medicaid managed care provider networks to ensure cost efficiency and access to adequate in-network care. The audit covered the period from January 2023 through … Medicaid members receive their services through managed care. DOH is responsible for ensuring that managed care …
https://www.osc.ny.gov/state-agencies/audits/2025/10/22/medicaid-program-oversight-managed-care-provider-networksMedicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… Objective To determine if Medicaid made overpayments to providers who reported claims with a PR … to the provider, explaining the reason for any adjustments made to the claim amount. Claim Adjustment Reason Codes … codes on ERAs that detail the reason an adjustment was made to a claim and assign financial responsibility for the …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations included in our initial audit report … Hours of Work for Nurses (Report 2017-S-14 ). About the Program The Department of Labor (Department) is … To determine the extent of implementation of the five recommendations …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-followProblem Gambling Treatment Program
… Key Findings OASAS has not conducted a comprehensive needs assessment or social impact study to identify the number or … efforts. Key Recommendations Conduct a comprehensive needs assessment and social impact study for problem gambling. …
https://www.osc.ny.gov/state-agencies/audits/2019/02/05/problem-gambling-treatment-programCUNY Bulletin No. CU-653
… Conversion (MSC) Program. Employees receive an annual incentive payment in exchange for waiving their City health …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-653-city-university-new-york-cuny-health-benefits-buy-outDiNapoli: Tax Collector Sentenced for Dodging Her Own Tax Bills
… Thomas P. DiNapoli’s office. St. Lawrence County Court Judge Jerome J. Richards sentenced Sheppard based on her …
https://www.osc.ny.gov/press/releases/2015/10/dinapoli-tax-collector-sentenced-dodging-her-own-tax-billsPrograms for Little Learners – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Programs For … York. PFLL provides preschool special education services to children with learning disabilities who are between three … financial information, including costs, that PFLL reports to SED on its annual CFR. To be eligible for reimbursement, …
https://www.osc.ny.gov/state-agencies/audits/2018/09/24/programs-little-learners-compliance-reimbursable-cost-manualCUNY Bulletin No. CU-620
… Purpose To provide agency instructions for processing the CUNY Health Benefits Buy-Out Waiver Program. Affected … Eligible CUNY employees who elect to participate in the Health Benefits Buy-Out Waiver Program Background The Health Benefits Buy-Out Waiver Program is authorized …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-620-city-university-new-york-cuny-health-benefits-buy-outMonitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance (Follow-Up)
… all not-for-profit cemetery corporations (cemeteries) in New York State. As authorized by Article 15 of the …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/monitoring-not-profit-cemeteries-fiscal-stability-and-adequate-facility-maintenance-followLeake and Watts Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Leake and Watts Services, Inc. (Leake and Watts) on its Consolidated Fiscal Report (CFR) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) … To determine whether the costs reported by Leake and Watts Services Inc on its Consolidated Fiscal Report were …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/leake-and-watts-services-inc-compliance-reimbursable-cost-manualHawthorne Foundation, Inc. – Compliance With the Reimbursable Cost Manual
… with disabilities who are between three and five years of age. Hawthorne is reimbursed for preschool special … in other than personal service costs, which consisted of $11,419 in expensed equipment that was not properly … tuition reimbursement rates. Remind Hawthorne officials of the pertinent SED requirements that relate to the …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/hawthorne-foundation-inc-compliance-reimbursable-cost-manualCUNY Bulletin No. CU-636
… Conversion (MSC) Program. Employees receive an annual incentive payment in exchange for waiving their City health …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-636-city-university-new-york-cuny-health-benefits-buy-outWest Henrietta Fire Department, Inc. – Treasurer (2025M-104)
… jeopardize a fire department’s funding and its mission. From January 1, 2023 through December 31, 2024, the … totaling $2,219 in a Department bank account within 10 days of receipt, as required by Department bylaws. Maintain … in this report and forward it to our office within 90 days. For more information on preparing and filing your …
https://www.osc.ny.gov/local-government/audits/fire-company-or-department/2025/12/19/west-henrietta-fire-department-inc-treasurer-2025m-104