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State Agencies Bulletin No. 2086.1
… version AC 2772 (Rev. 12/2022) should be accepted. All links to the AC 2772 form on agency internet pages should be …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/20861-updated-direct-deposit-guidanceEmpire BlueCross – Overpayments for Physician-Administered Drugs (Follow-Up)
… coverage. Civil Service contracts with Anthem Blue Cross (Anthem), formerly Empire BlueCross, to administer the …
https://www.osc.ny.gov/state-agencies/audits/2025/06/04/empire-bluecross-overpayments-physician-administered-drugs-followMedicaid Program – Claims Processing Activity April 1, 2024 Through September 30, 2024
… increased payments. $222,220 was paid for inpatient, clinic, and referred ambulatory claims that did not comply …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/medicaid-program-claims-processing-activity-april-1-2024-through-september-30-2024Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)
… initial audit report, Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under … The Empire Plan is the primary health benefits plan for NYSHIP, covering over 1 million members. Civil Service … CVS Caremark to administer the prescription drug program for the Empire Plan. This program includes a Commercial Plan …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-underMedicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… Objective To determine whether the Department of Health (DOH) provided adequate oversight to ensure managed care recipients in the Recipient Restriction Program received … must receive certain care through only their designated health care providers or via referral from those providers. …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientAnthem Blue Cross – Effectiveness of the Recovery Process
… Objective To determine whether Anthem Blue Cross (Anthem) effectively administered the recovery process … To determine whether Anthem Blue Cross Anthem effectively administered the recovery process …
https://www.osc.ny.gov/state-agencies/audits/2026/01/06/anthem-blue-cross-effectiveness-recovery-processLegal Topics and Approvals
… Advisory Legal Opinions Local Debt Refunding: Procedures for Seeking … Request these publications from the Division of Legal Services at (518) 474-5586: Application Forms for … Law, §103 (March, 2010): A research paper discussing the legal requirements in connection with competitive bidding for …
https://www.osc.ny.gov/local-government/resources/legal-topics-and-approvalsMedicaid Program – Inappropriate Payments Related to Procedure Modifiers
… Medicaid program in New York State. Health care providers bill Medicaid for services provided to Medicaid recipients. … and management (E/M) services, are included in Medicaid’s payment for the procedure. E/M services that are unrelated to … costs of the services were already included in Medicaid’s payment for the surgical procedures. Medicaid also made …
https://www.osc.ny.gov/state-agencies/audits/2018/04/17/medicaid-program-inappropriate-payments-related-procedure-modifiersHawthorne Foundation, Inc. – Compliance With the Reimbursable Cost Manual
… special education provider located in Westchester County, New York. Hawthorne provides preschool special education services …
https://www.osc.ny.gov/state-agencies/audits/2017/10/06/hawthorne-foundation-inc-compliance-reimbursable-cost-manualPrograms for Little Learners – Compliance With the Reimbursable Cost Manual
… disabilities who are between three and four years of age. PFLL is reimbursed for preschool special education … regional median compensation for an Executive Director, $4,084 in unsupported salary costs, $749 in medical expenses …
https://www.osc.ny.gov/state-agencies/audits/2018/09/24/programs-little-learners-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… reported by Brookville Center for Children’s Services, Inc. (Brookville) on its Consolidated Fiscal Reports (CFRs) … programs. During the same three fiscal years, NYSARC, Inc. - Nassau County Chapter (AHRC), a related party, … Manual ( 2015-S-19 ) New York League for Early Learning, Inc.: Compliance With the Reimbursable Cost Manual ( …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualImproper Payments to a Physical Therapist (Follow-Up)
… found that Medicaid overpaid Mr. Amir $146,225 for 3,837 claims that were submitted to the Medicaid program with … In addition, our audit questioned the propriety of 5,634 claims totaling $158,990 because Mr. Amir submitted claims using his National Provider Identifier for services that were rendered by other …
https://www.osc.ny.gov/state-agencies/audits/2016/12/08/improper-payments-physical-therapist-followMill Neck Manor School for the Deaf – Compliance With the Reimbursable Cost Manual
… on its Consolidated Fiscal Reports CFRs were properly ca …
https://www.osc.ny.gov/state-agencies/audits/2013/03/14/mill-neck-manor-school-deaf-compliance-reimbursable-cost-manualSelected Aspects of Inactive Hazardous Waste Site Remediation Cost Recovery
… State costs related to site investigation and remediation, bill for and collect these costs from responsible parties in … billing process and the timeliness of billing. However, bill preparation is a very time-consuming process and billing … which delays recovery of some State costs until the next bill is prepared. We reviewed 21 bills for eight sites and …
https://www.osc.ny.gov/state-agencies/audits/2015/01/22/selected-aspects-inactive-hazardous-waste-site-remediation-cost-recoverySelected Financial Management Practices
… The audit covered the period April 1, 2010 through March 26, 2014. Background The Hudson River Park Trust (Trust) is a …
https://www.osc.ny.gov/state-agencies/audits/2014/12/26/selected-financial-management-practicesImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… State’s Medicaid program provides a wide range of health care services, including prescription drugs, to individuals … care needs. The New York State Controlled Substances Act (Act) was enacted to combat the illegal use of controlled …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followUnity House of Troy – Compliance With the Reimbursable Cost Manual
… 31, 2012. Background Unity is an SED-approved, not-for-profit special education provider located in Troy, New York. Unity … category, too many hours per day for certain direct care positions, and the personal service costs for one of its …
https://www.osc.ny.gov/state-agencies/audits/2015/11/05/unity-house-troy-compliance-reimbursable-cost-manualPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… we identified, formally assess the payments we did not test, and formally assess the conduct of William Davis. Key …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followThe Arc of Orange County – Compliance With the Reimbursable Cost Manual
… provides preschool special education services to children with disabilities who are between the ages of three and five … be eligible for reimbursement, reported costs must comply with RCM requirements. For the calendar year ended December … Ensure that costs reported on annual CFRs fully comply with SED’s requirements, and communicate with SED to obtain …
https://www.osc.ny.gov/state-agencies/audits/2016/03/17/arc-orange-county-compliance-reimbursable-cost-manualMilestone School for Child Development – Compliance With the Reimbursable Cost Manual
… school year, Milestone serviced about 110 students. The New York City Department of Education (DoE) refers students to …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manual