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Medicaid 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-processMilestone School for Child Development – Compliance With the Reimbursable Cost Manual
… 110 students. The New York City Department of Education (DoE) refers students to Milestone based on clinical … and properly documented. SED reimburses DoE for a portion of its payments to Milestone based on …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualCity of Glen Cove – Budget Review (B7-16-12)
… the significant revenue and expenditure projections in the City’s preliminary budget for the 2017 fiscal year are reasonable. Background The City of Glen Cove, located in Nassau County, issued debt … the deficit obligations are outstanding. Key Findings City officials are projecting operating surpluses for the …
https://www.osc.ny.gov/local-government/audits/city/2016/10/14/city-glen-cove-budget-review-b7-16-12Selected Financial Management Practices
… boundary of Battery Place to the northern boundary of 59th Street in Manhattan. The Trust has authority over the …
https://www.osc.ny.gov/state-agencies/audits/2014/12/26/selected-financial-management-practicesElmcrest Children’s Center, Inc. – Compliance With the Reimbursable Cost Manual
… Audits/Reports of Interest The Arc of Orange County: Compliance With the Reimbursable Cost Manual (2015-S-45) Center for Disability Services: Compliance With the Reimbursable Cost Manual (2015-S-40) …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/elmcrest-childrens-center-inc-compliance-reimbursable-cost-manualState Agencies Bulletin No. 2238
… is lapsing on 6/28/2024, agencies will need to insert a new row into the Department Budget Table USA (refer to Job …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2238-updating-payserv-chartfield-strings-june-lapsing-eventsState Comptroller DiNapoli Releases State Audits
… by traditional carriers decreased with reliance on black car services and taxis increasing. Auditors found AAR and the … was an unquantified liability risk associated with black car services and taxis that was expanding and was not being … by traditional carriers decreased with reliance on black car services and taxis increasing …
https://www.osc.ny.gov/press/releases/2016/05/state-comptroller-dinapoli-releases-state-audits-0State Agencies Bulletin No. 2152.1
… with one or more uncashed payroll checks originally issued in calendar year 2022 are affected. Background: Abandoned … of 2023. A second outreach letter was mailed via certified mail to all employees with a 2022 uncashed payroll check … website to search for money escheated to OUF and submit a claim to recover funds. Questions: Questions regarding this …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/21521-outreach-and-escheatment-2022-uncashed-nys-payroll-checksDiNapoli: Former Treasurer Pleads Guilty to Felony in Theft of More Than $5,000 in Fire District Funds
… money for personal gain,” DiNapoli said. “Such crimes can be deterred by proper oversight. The first line of … response is included in the final audit report, which can be viewed here: … the public to help fight fraud and abuse. New Yorkers can report allegations of fraud involving taxpayer money by …
https://www.osc.ny.gov/press/releases/2015/05/dinapoli-former-treasurer-pleads-guilty-felony-theft-more-5000-fire-district-fundsService Diversions for Maintenance and Capital Projects
… Purpose To determine whether the MTA Long Island Rail Road (LIRR) (1) effectively managed service diversions due to … To determine whether the MTA Long Island Rail Road LIRR 1 effectively managed service diversions due to …
https://www.osc.ny.gov/state-agencies/audits/2014/03/18/service-diversions-maintenance-and-capital-projectsReimbursement of Social Services Costs (2013MS-3)
… delivering services to, or for, the DSS at rates up to 50 percent from the Federal government and 25 percent from … errors (under-billings and over-billings) or a failure to bill at all. We identified additional opportunities for … to the DSS in an effort to accurately capture and bill direct expenditures related to social services. Maintain …
https://www.osc.ny.gov/local-government/audits/county/2013/12/13/reimbursement-social-services-costs-2013ms-3Medicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement
… for drugs from manufacturers that did not enter into a national drug rebate agreement (NDRA). The audit covered the … for drugs from manufacturers that did not enter into a national drug rebate agreement NDRA …
https://www.osc.ny.gov/state-agencies/audits/2024/02/23/medicaid-program-improper-payments-drugs-without-federal-drug-rebate-agreementDiNapoli: State Tax Receipts Exceeded Updated Projections in First Quarter
… in part, the impact of slower income growth and financial market volatility in 2022 on collections from returns in …
https://www.osc.ny.gov/press/releases/2023/07/dinapoli-state-tax-receipts-exceeded-updated-projections-first-quarter