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Inappropriate Medicaid Payments for Recipients With Multiple Identification Numbers and No Social Security Numbers (Follow-Up)
… made in our audit report, Inappropriate Medicaid Payments for Recipients with Multiple Identification Numbers and No … assigned identification numbers to individuals eligible for Medicaid, and whether inappropriate Medicaid payments … The Department oversees and establishes guidelines for local districts regarding Medicaid eligibility. Local …
https://www.osc.ny.gov/state-agencies/audits/2014/08/06/inappropriate-medicaid-payments-recipients-multiple-identification-numbers-and-no-socialOverpayments of Certain Medicare Crossover Claims (Follow-Up)
… Purpose To determine the extent of implementation of the five … Individuals enrolled in both programs are referred to as “dual-eligibles.” Generally, Medicare is the primary payer for medical services provided to dual-eligibles. Medicaid then typically pays for any …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followMedicaid Payments for Excessive Dental Services (Follow-Up)
… included in our initial audit report, Medicaid Payments for Excessive Dental Services (Report 2009-S-46). Background … issued on August 16, 2010, examined Medicaid payments for routine dental services, such as cleanings and oral … that if the Department adjusted its Medicaid fees for these services to the averages of other comparable …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/medicaid-payments-excessive-dental-services-followContract with EBSCO Subscription Services, Inc. (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … which was issued on August 12, 2010, examined the Office of General Services’ (OGS) administration of contracts for … To determine the extent of implementation of the three recommendations included in …
https://www.osc.ny.gov/state-agencies/audits/2013/05/13/contract-ebsco-subscription-services-inc-followReporting and Utilization of Bias Incident Data
… and reporting bias incident statistics and utilizing the da …
https://www.osc.ny.gov/state-agencies/audits/2014/09/25/reporting-and-utilization-bias-incident-dataUnnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)
… audit report, Unnecessary Managed Care Payments for Medicaid Recipients With Medicare (Report 2010-S-75). … Department of Health (Department) made premium payments to Medicaid managed care plans for Medicaid recipients who also had Medicare health insurance … initial audit report Unnecessary Managed Care Payments for Medicaid Recipi …
https://www.osc.ny.gov/state-agencies/audits/2013/11/01/unnecessary-managed-care-payments-medicaid-recipients-medicare-followMedicaid Payments for Medicare Part A Beneficiaries (Follow-Up)
… made in our audit report, Medicaid Payments for Medicare Part A Beneficiaries (2009-S-36). Background Our … 20, 2010, examined whether Medicaid made overpayments for recipients who were also enrolled in Medicare Part A. … Medicare Part A provides supplementary medical insurance for inpatient care in hospitals, post-hospital nursing home …
https://www.osc.ny.gov/state-agencies/audits/2014/04/04/medicaid-payments-medicare-part-beneficiaries-followNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… initial report Group Health Incorporated: New York State Dental Program - Payments for Scaling and Root Planing … 1, 2005 through December 31, 2008. New York State provides dental insurance benefits to certain State employees and … contracts with Group Health Incorporated (GHI) to process dental claims on behalf of the State. Emblem Health is the …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… our initial audit report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of … adjudicates a claim, Medicaid pays the balance that is not covered by Medicare and would otherwise be the financial … generally would pay deductibles and coinsurance not covered by Medicare. Our initial audit report, which was …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followManagement of General School Funds (Follow-Up)
… John F. Kennedy Educational Campus: Management of General School Funds (Report 2009-N-11). Background Our initial … Campus staff with adequate oversight and training and that school officials did not exercise due diligence and care over General School Fund (GSF) accounts. We could not fully account for …
https://www.osc.ny.gov/state-agencies/audits/2014/09/30/management-general-school-funds-followVehicle and Heavy Equipment Purchase Program (Follow-Up)
… Port Authority included funds for vehicle and equipment rentals in its annual Purchase Program. We also found that the car service contract amounts were excessive compared to the …
https://www.osc.ny.gov/state-agencies/audits/2014/11/03/vehicle-and-heavy-equipment-purchase-program-followManagement and Control of Employee Overtime Costs (Follow-Up)
… report, issued on August 17, 2011, determined that the Port Authority of New York and New Jersey (Port Authority) generally did not effectively manage and … proper prior approvals and justification. In addition, the Port Authority did not meet the 20 percent overtime reduction …
https://www.osc.ny.gov/state-agencies/audits/2014/12/19/management-and-control-employee-overtime-costs-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… of the five recommendations made in our audit report, Unnecessary Medicaid Payments for Children at Voluntary Agencies (2010-S-47). Background Our initial audit report, which was issued on September 19, 2012, examined … of the five recommendations made in our audit report Unnecessary Medicaid Payments for Children at …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followTuition Assistance Program – State Financial Aid Program at Barnard College
… is a women’s liberal arts college. Located in Manhattan, near Columbia University, students at both schools can enroll …
https://www.osc.ny.gov/state-agencies/audits/2015/08/03/tuition-assistance-program-state-financial-aid-program-barnard-collegeImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… needed. Of the initial report’s five recommendations, two were implemented, two were partially implemented, and one was not implemented. …
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followMedicaid Program – Medicaid Claims Processing Activity April 1, 2014 Through September 30, 2014
… payments for HIV tests, duplicate billings, and clinic, practitioner, and health home services. By the end of the …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014Circle of Friends – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs submitted by Circle of Friends on its Consolidated Fiscal Reports (CFRs) … covered the fiscal year ended June 30, 2013. Background Circle of Friends provides preschool special education … in the RCM. For the fiscal year ended June 30, 2013, Circle of Friends claimed about $1.1 million in reimbursable …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/circle-friends-compliance-reimbursable-cost-manualBright Start Pediatric Services, LLC – Compliance With the Reimbursable Cost Manual
… Manual (RCM). The audit covered the fiscal year ended June 30, 2013. Background Bright Start provides preschool special … reported by providers on their annual CFR. To be eligible for reimbursement, the provider's reported costs must comply with the guidelines specified in the RCM. For the fiscal year ended June 30, 2013, Bright …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/bright-start-pediatric-services-llc-compliance-reimbursable-cost-manualEarly Childhood Education Center – Compliance With the Reimbursable Cost Manual
… calculated, adequately documented, and allowable under the State Education Department’s (SED’s) guidelines, including … between the ages of three and five years. Pursuant to the State Education Law, providers such as ECEC are reimbursed by … requirements. Other Related Audits/Reports of Interest State Education Department: The Norman Howard School - …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/early-childhood-education-center-compliance-reimbursable-cost-manualMilestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the Milestone School for Child Development (Milestone) on its … documented, program related, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost … Determine whether the costs reported by Milestone School for Child Development …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manual