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Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance (Follow-Up)
… percent) was not recoverable per the Medicaid Managed Care Model Contract (Model Contract) because the managed care organization and … with comprehensive TPHI from managed care; and amend the Model Contract to allow the Department to recover premiums …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/managed-care-premium-payments-recipients-comprehensive-third-party-insurance-followOversight of Hazardous Materials and Waste (Follow-Up)
… Objective To assess the extent of implementation of the three recommendations included in our initial audit … of Hazardous Materials and Waste ( 2017-S-51 ). About the Program Our initial report, covering the period January … To assess the extent of implementation of the three recommendations …
https://www.osc.ny.gov/state-agencies/audits/2020/01/30/oversight-hazardous-materials-and-waste-followBehavior Analysts of New York, LLC – Compliance With the Reimbursable Cost Manual
… allowable, properly calculated, and adequately documented in accordance with applicable State Education Department … reporting year ended June 30, 2015, BANY reported $245,613 in reimbursable costs for its Special Education Itinerant … these services to 18 children from 12 school districts in Westchester County. Key Findings For the reporting period …
https://www.osc.ny.gov/state-agencies/audits/2020/01/31/behavior-analysts-new-york-llc-compliance-reimbursable-cost-manualHebrew Academy for Special Children, Inc. – Compliance With the Reimbursable Cost Manual
… Special Class (SC), and full- and half-day Special Class in an Integrated Setting (SCIS) programs to children with … under these programs and under the SEIT program effective in the 2015-16 fiscal year are based on fixed fees. Hebrew … year, Hebrew Academy served approximately 539 students in its SED preschool cost-based programs. The New York City …
https://www.osc.ny.gov/state-agencies/audits/2020/02/04/hebrew-academy-special-children-inc-compliance-reimbursable-cost-manualDo Not Call Enforcement Efforts (Follow-Up)
… consumers to register their personal mobile and landline phone numbers on a central national registry to reduce … their phone numbers on a statewide registry. In 2003, the Federal Trade Commission (FTC) and the Federal Communications … by State residents had more than doubled since 2014, the number of cases referred to counsel for further action …
https://www.osc.ny.gov/state-agencies/audits/2020/02/19/do-not-call-enforcement-efforts-followEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with … rate schedules for the payment of inpatient and outpatient hospital services. Hospitals may be entitled to additional …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followEmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits
… EmblemHealth Plan, Inc. overpaid dental claims for members covered by two subscriber plans under the New York State Dental Insurance Program. The audit covered the period from January … use for paying health care claims when an individual is covered by more than one insurance plan. This process …
https://www.osc.ny.gov/state-agencies/audits/2024/01/08/emblemhealth-plan-inc-overpayments-services-requiring-coordination-benefitsMaximizing Incentives for Individuals With Disabilities (Follow-Up)
… December 2023, 151 TTW providers (hereafter referred to as provider affiliates) were participating in NYESS. These provider affiliates provide customer support/services such as … one of the seven State agencies used NYESS. Additionally, provider affiliates did not fully utilize NYESS’ reporting …
https://www.osc.ny.gov/state-agencies/audits/2024/02/20/maximizing-incentives-individuals-disabilities-followArtificial Intelligence Governance
… Objective To assess New York City’s progress in establishing an appropriate governance structure over the … transportation, and government, enabling entities to operate more intelligently, more productively, and more … To assess New York Citys progress in establishing an …
https://www.osc.ny.gov/state-agencies/audits/2023/02/16/artificial-intelligence-governanceCompliance With Special Education Requirements – Evaluations (Follow-Up)
… Objective To determine the extent of implementation of the four … schools/students) and provided special education services to approximately 192,000 of these students in the 2021-22 … year. The DOE is responsible for evaluating students to determine their eligibility for special education services …
https://www.osc.ny.gov/state-agencies/audits/2023/03/15/compliance-special-education-requirements-evaluations-followOversight of Chemical Dependence Residential Services (Follow-Up)
… of the three recommendations included in our initial audit report, Oversight of Chemical Dependence … living, and intensive residential rehabilitation (our initial audit did not include a review of intensive … operating certificate expires. The objective of our initial audit, issued in December 2021, was to determine …
https://www.osc.ny.gov/state-agencies/audits/2023/10/30/oversight-chemical-dependence-residential-services-followOversight of New York State Forest Tax Programs (Follow-Up)
… in our initial audit report, Oversight of New York State Forest Tax Programs (Report 2020-S-51 ). About the Program … of 30.2 million acres comprises almost 19 million acres of forest, which provide many public benefits, including clean air and water, carbon storage, forest products (e.g., timber), jobs, scenic beauty, and …
https://www.osc.ny.gov/state-agencies/audits/2023/12/05/oversight-new-york-state-forest-tax-programs-followImplementation of the Security Guard Act (Follow-Up)
… of Licensing Services (Division), oversees the licensure, registration, and regulation of 36 occupations throughout New … that individuals working as security guards have a valid registration card, and entrusts the Department with issuing registration cards for all security guard applicants who meet …
https://www.osc.ny.gov/state-agencies/audits/2023/09/29/implementation-security-guard-act-followImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
… providers. When a hospital bills an MCO for an inpatient stay, the hospital reports certain information on its claims, … patient was transferred or discharged at the end of their stay. These codes are important because reimbursement …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followCompliance With School Safety Planning Requirements (Follow-Up)
… in 2000 in an effort to promote a safer and more effective learning environment within State schools. Further, the Education Law requires schools and school districts to take safety planning …
https://www.osc.ny.gov/state-agencies/audits/2024/01/11/compliance-school-safety-planning-requirements-followOversight of Building Construction Site Safety (Follow-Up)
… to issue Office of Administrative Trials and Hearings (OATH) Summonses and DOB Violations when a property or … the period January 2018 to December 2021, found that DOB’s oversight of building construction sites – including … required codes, rules, and regulations. Additionally, DOB’s enforcement activities provided limited assurance that …
https://www.osc.ny.gov/state-agencies/audits/2024/01/10/oversight-building-construction-site-safety-followOversight of Persons Convicted of Driving While Intoxicated (Follow-Up)
… checks and/or did not refer stipulated IID violation alerts to the appropriate courts, district attorneys, and …
https://www.osc.ny.gov/state-agencies/audits/2018/11/29/oversight-persons-convicted-driving-while-intoxicated-followNew York Youth Jobs Program
… and Finance. Background The Program, which was established in 2011 under section 25-a of the New York State Labor Law … is intended to create jobs and spur economic growth in the State by establishing incentives for employers to hire … unemployed, disadvantaged youth aged 16 to 24 who live in New York State, with a focus on 13 cities and towns. Labor …
https://www.osc.ny.gov/state-agencies/audits/2019/01/09/new-york-youth-jobs-programSecurity Over Critical Information Systems (Follow-Up)
… Purpose To determine the extent of implementation of the two recommendations included in our initial audit report, … which was issued on July 19, 2017, determined whether the security controls over critical State Education … To determine the extent of implementation of the two recommendations …
https://www.osc.ny.gov/state-agencies/audits/2018/11/13/security-over-critical-information-systems-followYork College – Time and Attendance Practices for Public Safety Staff (Follow-Up)
… Purpose To determine the extent of implementation of the seven recommendations included in our initial audit … cameras found that security officers who were assigned to the fire watch spent long periods of time in one area … To determine the extent of implementation of the seven …
https://www.osc.ny.gov/state-agencies/audits/2018/12/28/york-college-time-and-attendance-practices-public-safety-staff-follow