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Medicaid Program – Medicaid Claims Processing Activity April 1, 2011 Through September 30, 2011
… levels of care; Claims for a recipient who did not live in New York State; and Improper claims for certain …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/medicaid-program-medicaid-claims-processing-activity-april-1-2011-through-september-30-2011Children’s Center for Early Learning – Compliance With the Reimbursable Cost Manual
… the Consolidated Fiscal Reports (CFRs) of the Children’s Center for Early Learning (Center) were calculated properly, documented adequately, and … from fiscal years 2005-06 and 2006-07. Background The Center provides special education services to New York … reported on the Consolidated Fiscal Reports CFRs of the Childrens Center for Early Learning Center were calculated …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/childrens-center-early-learning-compliance-reimbursable-cost-manualMetro Therapy, Inc. – Compliance With the Reimbursable Cost Manual
… reported on the Consolidated Fiscal Reports (CFRs) of Metro Therapy, Inc. (Metro Therapy) were calculated properly, documented … the three fiscal years ended June 30, 2011. Background Metro Therapy is based in Hauppauge, New York and provides … costs reported on the Consolidated Fiscal Reports CFRs of Metro Therapy Inc Metro Therapy were calculated properly …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/metro-therapy-inc-compliance-reimbursable-cost-manualMedicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
… to the providers. The audit covered the period April 1, 2013 through September 30, 2013. Background The Department … or questionable Medicaid payments, including: $1,822,467 in payments for pharmacy claims that posed patient … and policies necessary for payment of the claims; $1,826,725 in overpayments for inpatient claims that providers …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013Contracted Programs With Puerto Rican Organization to Motivate, Enlighten and Serve Addicts, Inc.
… Organization to Motivate, Enlighten and Serve Addicts, Inc. (PROMESA) to ensure that claims are allowable, properly … of $2.8 million, of which OASAS funded $2.3 million. Key Findings We found that despite two relatively recent … the one with PROMESA, require a significant commitment of resources to adequately address the scope of work required to …
https://www.osc.ny.gov/state-agencies/audits/2016/06/08/contracted-programs-puerto-rican-organization-motivate-enlighten-and-serve-addicts-incMedicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
… to the providers. The audit covered the period October 1, 2013 through March 31, 2014. Background The Department of … million in inappropriate Medicaid payments, including: $1,335,151 in overpayments for hospital claims for which … of Health: Medicaid Claims Processing Activity October 1, 2012 Through March 31, 2013 (2012-S-131) Department of …
https://www.osc.ny.gov/state-agencies/audits/2015/05/21/medicaid-program-medicaid-claims-processing-activity-october-1-2013-through-march-31-2014Medicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… Purpose To determine whether the Department of Health paid pharmacy … of health care services, including prescription drugs, to individuals who are economically disadvantaged and/or have … State Controlled Substances Act (Act), which was enacted to combat illegal use of controlled substances, limits the …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsSocial Adult Day Services
… of Health (DOH), are effectively overseeing Social Adult Day Services (SADS) programs to ensure that providers comply … of Health are effectively overseeing Social Adult Day Services prog …
https://www.osc.ny.gov/state-agencies/audits/2015/12/02/social-adult-day-servicesOverpayments to Cabrini Medical Center (Follow-Up)
… of Health: Overpayments to Cabrini Medical Center (2011-S-8) …
https://www.osc.ny.gov/state-agencies/audits/2013/11/07/overpayments-cabrini-medical-center-followTuition Assistance Program – State Financial Aid Program at Barnard College
… humanities, social sciences and natural sciences. Annual tuition for full-time students is approximately $44,300 per … entitlement program designed to provide funds for paying tuition costs to eligible students. Schools receiving State … in the report. Other Related Audits/Reports of Interest Tuition Assistance Program - New York Career Institute …
https://www.osc.ny.gov/state-agencies/audits/2015/08/03/tuition-assistance-program-state-financial-aid-program-barnard-collegePublic School Safety – Incident Reporting and Unauthorized Student Departures
… limits are designated “Persistently Dangerous” (PD) or “Potentially Persistently Dangerous” (PPD). Officials of PD schools are required to notify parents of their option to … another school within the district that is not designated PD. Key Findings Our review of 10 sampled schools found that …
https://www.osc.ny.gov/state-agencies/audits/2015/04/29/public-school-safety-incident-reporting-and-unauthorized-student-departuresMedicaid Program – Medicaid Claims Processing Activity April 1, 2014 Through September 30, 2014
… by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments … methodology; $402,927 in overpayments for claims billed with incorrect information pertaining to other health … payments for pharmacy claims that were not in compliance with State Medicaid policies; $252,022 in overpayments for …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-medicaid-claims-processing-activity-april-1-2014-through-september-30-2014Assertive Community Treatment Program
… effectively overseeing the Assertive Community Treatment (ACT) program to ensure that ACT provider teams are complying with requirements and that … One way the Office accomplishes its mission is through the ACT program, which uses evidence-based practices to provide …
https://www.osc.ny.gov/state-agencies/audits/2015/05/06/assertive-community-treatment-program2014 Year End Report
… Workers’ Compensation Law and New York State’s mandated fee schedules. Background The Board administered four sole … and SFCC process claims from the Fund for Reopened Cases. Payment data is entered into the Board’s automated payment system, where the claims are subjected to various system …
https://www.osc.ny.gov/state-agencies/audits/2015/03/30/2014-year-end-reportMedicaid Program – Eye Care Provider and Family Inappropriately Enroll as Recipients and Overcharge for Vision Services
… in New York State. Medicaid provides a wide range of medical services, including vision care, to individuals who … income information to secure Medicaid coverage and other medical assistance benefits. During the period of enrollment … owner and the owner’s family, the State paid $68,483 in medical benefits on their behalf. The Provider received over …
https://www.osc.ny.gov/state-agencies/audits/2016/03/21/medicaid-program-eye-care-provider-and-family-inappropriately-enroll-recipients-andHate Crime Reporting
… Justice Services (Division) adequately monitors hate crime reporting and takes steps to ensure complete and … city, and local police agencies (agencies) to report crime data, including hate crimes, to the Division. Crimes … practice, age, disability, or sexual orientation. Hate crime incidents that agencies report to the Division include …
https://www.osc.ny.gov/state-agencies/audits/2014/09/25/hate-crime-reportingSelected Payments for Special Items Made to Stony Brook University Hospital from January 1, 2011 through March 31, 2011
… to State University of New York's Stony Brook University Hospital (Stony Brook) for special items were made according … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they … to State University of New Yorks Stony Brook University Hospital Stony Brook for special it …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-stony-brook-university-hospital-january-1-2011-throughEmpire BlueCross BlueShield – Selected Payments for Special Items Made to Saratoga Hospital From January 1, 2011 Through March 31, 2011
… and Saratoga. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-made-saratoga-hospital-januarySelected Payments for Special Items Made to Mary Imogene Bassett Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield’s (Empire’s) payments to Mary Imogene Bassett Hospital (Bassett) for special items … To determine if BlueCross BlueShields Empires payments to Mary Imogene Bassett Hospital Bassett for special items were …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-mary-imogene-bassett-hospital-january-1-2011-throughCompliance With State Arts Education Requirements
… (NYC) Department of Education (DoE) students completed an Arts education curriculum that complied with State Education Department Regulations. Background Arts education-related studies conclude that an Arts education reduces the risk of students dropping out of …
https://www.osc.ny.gov/state-agencies/audits/2014/02/28/compliance-state-arts-education-requirements