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Medicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… overpaid hospitals by reimbursing for higher levels of medical care than those actually provided to patients. The … March 31, 2010. Background Medicaid recipients in need of inpatient hospital care are provided a full range of necessary diagnostic, palliative and therapeutic care, …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissionsAll Services for Kids, Inc. – Compliance With the Reimbursable Cost Manual
… 2010. Background All Services, located in Fresh Meadows, New York, provided special education itinerant teacher … with disabilities between the ages of three and five. The New York City Department of Education (DoE) paid All Services …
https://www.osc.ny.gov/state-agencies/audits/2014/02/25/all-services-kids-inc-compliance-reimbursable-cost-manualMedicaid Program – Improper Payments of Medicare Buy-in Premiums for Ineligible Recipients
… Objective To determine if Medicaid made improper Medicare premium … Medicare buy-in program credits from January 1, 2015 to November 30, 2020. About the Program The Department of … We found that the Department needs additional controls to ensure timely Buy-in Program eligibility determinations …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-payments-medicare-buy-premiums-ineligible-recipientsOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… included in our initial audit report, Overpayments for Therapy Services and Prescription Drugs Covered by … overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered … covered the period January 1, 2012 to December 31, 2016 for prescription drugs and January 1, 2012 to December 31, …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital … schedules. Intraocular lenses are used in the treatment of cataracts – the clouding of the lens in the eye – which cause vision problems. A …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsManaged Care Premium Payments for Recipients With Comprehensive Third-Party Insurance (Follow-Up)
… of implementation of the seven recommendations made in our initial audit report, Managed Care Premium Payments for … promptly disenrolling them from managed care. We issued our initial audit report on June 13, 2018. The audit … the period January 1, 2012 through September 1, 2017. Our audit identified $1.28 billion in premiums that were paid …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/managed-care-premium-payments-recipients-comprehensive-third-party-insurance-followOpioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program (Follow-Up)
… The audit objective was to determine if the Department of Health (Department) had taken sufficient steps to safeguard … dangerous prescriptions if Treatment Programs did not check I-STOP and, where authorized, coordinate care with … – auditors noted 493 of the 18,786 recipients required medical care as a result of opioid or narcotic overdoses that …
https://www.osc.ny.gov/state-agencies/audits/2020/05/07/opioid-prescriptions-medicaid-recipients-opioid-treatment-program-followMedicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY (Follow-Up)
… of implementation of the five recommendations included in our initial audit report, Medicaid Overpayments for … Program. Many Medicaid recipients are also enrolled in Medicare Part B (Part B), which provides supplemental … through May 31, 2017 and identified up to $8.7 million in improper payments for Part B deductibles and coinsurance. …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-part-b-services-billed-directly-emedny-followMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement
… managed care organizations (MCOs) a monthly capitation payment for each Medicaid recipient enrolled in their plans. …
https://www.osc.ny.gov/state-agencies/audits/2024/02/23/medicaid-program-improper-payments-drugs-without-federal-drug-rebate-agreementCompliance With Special Education Regulations for the Provision of Services (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations included in the initial audit report, … issues identified in the initial report. Of the report’s five recommendations, three were partially implemented and … To determine the extent of implementation of the five recommendations included in the initial audit report …
https://www.osc.ny.gov/state-agencies/audits/2023/03/15/compliance-special-education-regulations-provision-services-followMedicaid Program – Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition
… to a hospital will increase. Medicaid will only pay for medical care and services that are medically necessary, whose necessity is evident from … assessments and Medicaid billing rules; and Properly document severe malnutrition in a patient’s medical record. …
https://www.osc.ny.gov/state-agencies/audits/2019/04/08/medicaid-program-improper-medicaid-payments-recipients-diagnosed-severe-malnutritionNorthside Center for Child Development – Compliance With the Reimbursable Cost Manual
… with disabilities who are between three and five years of age. For purposes of this report, these programs are collectively referred to … five employees worked for the program or the allocation of costs for one employee. The Manual requires that providers …
https://www.osc.ny.gov/state-agencies/audits/2019/01/11/northside-center-child-development-compliance-reimbursable-cost-manualMedicaid Program – Improper Fee-for-Service Payments for Services Covered by Managed Care
… for certain services covered by mainstream managed care plans. Our audit covered the period January 1, 2013 to April … the managed care method, the Department pays managed care plans a monthly premium for each Medicaid recipient enrolled in managed care, and the managed care plans pay providers for services rendered to their members. …
https://www.osc.ny.gov/state-agencies/audits/2019/01/10/medicaid-program-improper-fee-service-payments-services-covered-managed-careMedicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (Follow-Up)
… made in our initial audit report, Medicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (Report 2013-S-4 ). … 31, 2012, the Department of Health (Department) paid Joia Pharmacy, Inc. (Joia) more than $7.7 million for 50,060 … made in our initial audit report Medicaid Payments for Pharmacy Claims Joia Pharmacy and a Related Prescriber Report …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriber-followYork College – Time and Attendance Practices for Public Safety Staff (Follow-Up)
… April 6, 2015, concluded that neither City University of New York (CUNY) nor York College had adequate internal controls over time and …
https://www.osc.ny.gov/state-agencies/audits/2018/12/28/york-college-time-and-attendance-practices-public-safety-staff-followGASB Statement No. 33 "Accounting and Financial Reporting for Nonexchange Transactions"
… No. 33 provides accounting and reporting guidelines for nonexchange transactions. A nonexchange transaction is … of nonexchange transaction: Derived tax revenues (for example income tax or sales tax). Imposed nonexchange revenues (for example real property taxes. Government-mandated …
https://www.osc.ny.gov/local-government/publications/gasb-statement-no-33-accounting-and-financial-reporting-nonexchange-transactionsDiNapoli: Audit Recommends Improvements in Services for Survivors of Human Trafficking
… “Programs exist to assist with shelter, medical and mental health care and legal services, but better monitoring of … who can assist with case management, legal services, health care or mental health counseling, and assistance with housing, food, or …
https://www.osc.ny.gov/press/releases/2025/03/dinapoli-audit-recommends-improvements-services-survivors-human-traffickingDiNapoli Releases 2024 Fiscal Stress Scores for Villages and Some Cities
… today announced that nine villages were designated in fiscal stress under his office’s Fiscal Stress Monitoring System (FSMS) for their fiscal year ending in 2024. DiNapoli’s office evaluated all non-calendar year local governments that filed their financial reports in time to be scored and designated three villages in …
https://www.osc.ny.gov/press/releases/2025/04/dinapoli-releases-2024-fiscal-stress-scores-villages-and-some-citiesDiNapoli: Timely Remediation Essential for Success of State's Brownfield Cleanup Program
… New York State Department of Environmental Conservation can strengthen its oversight and establish clear policies and … contaminated sites. Timelines for cleanup of a BCP site can vary depending on the severity of the contamination. The … media, such as groundwater, surface water, or soil, can be eligible for the BCP. The audit identified 27 sites …
https://www.osc.ny.gov/press/releases/2025/06/dinapoli-timely-remediation-essential-success-states-brownfield-cleanup-programDiNapoli: School District Tax Levy Cap at 2% for Third Straight Year
… will be capped at 2%, the same as last year, according to data released today by State Comptroller Thomas P. DiNapoli. The tax cap, which first applied to local governments (excluding New York City) and school districts in 2012, limits annual tax levy increases to the lesser of the rate of inflation or 2% with certain …
https://www.osc.ny.gov/press/releases/2024/01/dinapoli-school-district-tax-levy-cap-2-third-straight-year