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DiNapoli: State Tax Receipts Tracking Close to Projections Through First Half of the Year
… which was $2 billion, or 1.8%, higher than last year for the same period, primarily due to higher education costs. …
https://www.osc.ny.gov/press/releases/2024/10/dinapoli-state-tax-receipts-tracking-close-projections-through-first-half-yearMedicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… designated providers. The Office of the Medicaid Inspector General (OMIG) is responsible for administering and … and OMIG led to MCOs paying approximately $117 million for clinic, inpatient, practitioner, laboratory, and durable …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientDiNapoli: 1st Quarter State Tax Receipts Modestly Higher Than Division of Budget Projections
State tax receipts totaled $299 billion through the first quarter of State Fiscal Year SFY 202425 $594 million higher than estimates released by the Division of the Budget DOB in the Enacted Budget Financial Plan
https://www.osc.ny.gov/press/releases/2024/07/dinapoli-1st-quarter-state-tax-receipts-modestly-higher-division-budget-projectionsAnthem Blue Cross – Coordination of Benefits With Medicare
… plan. This process determines which insurance plan pays first as primary and which insurance plan pays secondary. Because the insurance company which pays primary typically pays the majority of the claim, it is …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareImproper Payments to a Physical Therapist (Follow-Up)
… 15, 2014. The audit objectives were to determine whether Mark Amir, a physical therapist who owned and operated …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… NYSARC, Inc. - Nassau County Chapter (AHRC), a related party, provided Brookville with management services under the …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualMedicaid Program – Medicaid Claims Processing Activity April 1, 2015 Through September 30, 2015
… Purpose To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … 2015 through September 30, 2015. Background The Department of Health (Department) administers the State’s Medicaid … 192 million claims, resulting in payments to providers of about $28.4 billion. The claims are processed and paid in …
https://www.osc.ny.gov/state-agencies/audits/2016/08/09/medicaid-program-medicaid-claims-processing-activity-april-1-2015-through-september-30-2015Unity House of Troy – Compliance With the Reimbursable Cost Manual
… the Reimbursable Cost Manual (RCM). Our audit covered the calendar year ended December 31, 2012. Background Unity is an … reported costs must comply with RCM requirements. For the calendar year ended December 31, 2012, Unity reported … With the Reimbursable Cost Manual (2013-S-48) Whitestone School for Child Development: Compliance With the …
https://www.osc.ny.gov/state-agencies/audits/2015/11/05/unity-house-troy-compliance-reimbursable-cost-manualImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… The State’s Medicaid program provides a wide range of health care services, including prescription drugs, to … who are economically disadvantaged and/or have special health care needs. The New York State Controlled Substances … dispense when prescriptions are ordered by telephone or fax. Our initial audit report, which was issued on February …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followThe Arc of Orange County – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by The Arc of Orange County (Arc Orange) on its Consolidated … To determine whether the costs reported by The Arc of Orange County Arc Orange on …
https://www.osc.ny.gov/state-agencies/audits/2016/03/17/arc-orange-county-compliance-reimbursable-cost-manualPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial audit report, which was issued on … Claims Submitted by Davis Ethical Pharmacy (2012-S-11) United HealthCare Insurance Program: Payments for …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-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 … We found that DOH lacked sufficient oversight of managed care provider networks. We determined that, in many … DOH has provided adequate oversight of Medicaid managed care provider networks to ensure cost efficiency and access …
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
… Group codes include PR (patient responsibility) and CO (contractual obligation). CARC 45 occurs when the charge … configured to pay in eMedNY, while claims with a CARC CO 45 are not. All claims submitted for Medicaid members with Medicare and/or other third-party insurance must accurately reflect payments, adjustments …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsSelected Aspects of Inactive Hazardous Waste Site Remediation Cost Recovery
… (Department) has effective systems in place to fully and accurately accumulate State costs related to site investigation and remediation, bill for and collect these costs from responsible parties in a timely … Department has effective systems in place to fully and accurately accumulate State costs rel …
https://www.osc.ny.gov/state-agencies/audits/2015/01/22/selected-aspects-inactive-hazardous-waste-site-remediation-cost-recoveryAnthem Blue Cross – Effectiveness of the Recovery Process
… Objective To determine whether Anthem Blue Cross (Anthem) effectively administered the recovery … To determine whether Anthem Blue Cross Anthem effectively administered the recovery …
https://www.osc.ny.gov/state-agencies/audits/2026/01/06/anthem-blue-cross-effectiveness-recovery-processIncorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)
… a Commercial Plan for members and their dependents who do not qualify for Medicare, and the Empire Plan Medicare Rx … Rx Plan) for retired members and their dependents who do qualify for Medicare. Claims paid under the Medicare Rx …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-underMedicaid Program – Claims Processing Activity April 1, 2024 Through September 30, 2024
… their claims. During the 6-month period ended September 30, 2024, eMedNY processed almost 249 million claims, …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/medicaid-program-claims-processing-activity-april-1-2024-through-september-30-2024Empire BlueCross – Overpayments for Physician-Administered Drugs (Follow-Up)
… members with four types of health insurance coverage: hospital, prescription drug, mental health and substance use, and medical/surgical … (Anthem), formerly Empire BlueCross, to administer the Hospital Program of the Empire Plan and to process and pay …
https://www.osc.ny.gov/state-agencies/audits/2025/06/04/empire-bluecross-overpayments-physician-administered-drugs-followState Agencies Bulletin No. 2346
… Purpose: The purpose of this bulletin is to inform agencies that position pools … July 10, 2025 OSC Actions: OSC has provided a spreadsheet of all current position pools that are affected by lapsing. A … their Appropriation Section Representative in OSC’s Bureau of State Accounting Operations to have this information …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2346-updating-payserv-chartfield-strings-june-lapsing-eventsVendor Responsibility Review Process
… the contract. This is an important part of the procurement process as it: helps ensure public dollars support honest …
https://www.osc.ny.gov/state-vendors/vendrep/vendor-responsibility-review-process