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Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… of implementation of the four recommendations included in our initial audit report, Overpayments to Managed Care … fixed monthly capitation payment for each newborn enrolled in the MCO. The MCO, in turn, is responsible for the provision of covered health … of implementation of the four recommendations included in our initial audit report Overpayments to Managed Care …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followNY-Sun Incentive Program
… commitment of $1 billion to stimulate the marketplace for solar energy in New York. NY-Sun aims to add more than three gigawatts (3 billion watts) of solar capacity, enough to power approximately 400,000 homes … is to help establish a self-sustaining and self-sufficient solar industry in the State. The roughly $1 billion will be …
https://www.osc.ny.gov/state-agencies/audits/2016/09/02/ny-sun-incentive-programMedicaid Program – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… this period, Davis Ethical was owned and operated by William Davis, a licensed pharmacist. Pursuant to allegations … made to Davis Ethical during the time it was owned by William Davis. Key Findings From January 1, 2008 through … payments, as warranted. Formally assess the conduct of William Davis and determine whether he should be allowed to …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/medicaid-program-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyPerformance Incentive Program
… its employees for meeting performance goals. A series of legal opinions and directives issued by various State … 2011-12 through 2013-14, the Authority distributed a total of $1.8 million in awards. Key Findings The Program, by design, directed the bulk of incentive awards to upper management. Upper management …
https://www.osc.ny.gov/state-agencies/audits/2015/02/27/performance-incentive-programCollection of Special Hauling and Divisible Load Overweight Permit Fees
… the Department of Transportation (Department) charged and collected the correct fees for special hauling and divisible load overweight permits. This audit covers the … is responsible for regulating the movement of oversize and overweight vehicles and loads on the State highway system …
https://www.osc.ny.gov/state-agencies/audits/2015/04/15/collection-special-hauling-and-divisible-load-overweight-permit-feesFood Safety Monitoring
… the processing, distribution and sale of food products in New York State. The audit covers the period April 1, 2011 … establishments, obtaining and analyzing food samples in support of its food safety/recall program, and … food sampling program is a nationally recognized leader in the field. However, all programs could benefit from …
https://www.osc.ny.gov/state-agencies/audits/2014/01/30/food-safety-monitoringAmusement Park and Fair Ride Safety
… site visits to conduct inspections of rides across the State. In 2013 alone, Department staff performed more than … rides offered at fixed-base amusement parks, the New York State Fair, and the many county fairs operated across the State are properly inspected and authorized before being …
https://www.osc.ny.gov/state-agencies/audits/2014/08/12/amusement-park-and-fair-ride-safetyUpstate Medical University's Billing Practices
… (e.g., service deemed not a medical necessity based on Medicare and other evidence-based criteria, or claim not …
https://www.osc.ny.gov/state-agencies/audits/2017/02/17/upstate-medical-universitys-billing-practicesOperational Advisory No. 32
… Adjustment Voucher should be submitted in SFS for OSC approval. All other revenue sources must be submitted … including related voucher identification and attachments for all ROA transactions submitted online or through a … field should contain information explaining the reason for the refund. There are, however, circumstances when the …
https://www.osc.ny.gov/state-agencies/advisories/operational-advisory/32-refund-appropriation-ap-adjustment-voucher-guidelinesAdministration of Self-Insured Workers’ Compensation Plans
… agencies administer their workers’ compensation plans to ensure they meet the self-insurers’ regulatory … agencies are administering their workers’ compensation plans to ensure they meet the self-insurers’ obligations. … selfinsured agencies administer their workers compensation plans to …
https://www.osc.ny.gov/state-agencies/audits/2020/09/25/administration-self-insured-workers-compensation-plansMedicaid Program – Improper Medicaid Payments for Misclassified Patient Discharges
… to reimburse hospitals for inpatient medical care. When a hospital bills Medicaid for an inpatient stay, the hospital reports certain information on its claims, such as … information is used to calculate the payment made to the hospital. Hospitals must also use certain patient status …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesAdministration and Collection of Real Estate Transfer Taxes (Follow-Up)
… our initial audit report, Administration and Collection of Real Estate Transfer Taxes (Report 2017-S-88 ). About the Program The Real Estate Transfer Tax (RETT), enacted in 1968 under Tax … our initial audit report Administration and Collection of Real Estate Transfer Taxes Report 2017S88 …
https://www.osc.ny.gov/state-agencies/audits/2021/10/27/administration-and-collection-real-estate-transfer-taxes-followLow-Income Housing Trust Fund Program (Follow-Up)
… Objective To determine the extent to which Homes and Community Renewal (HCR) implemented the recommendations in … the Program. The Corporation’s mission is to further community development through the construction, development, … that scored lower than others based on criteria such as community impact/revitalization, financial leveraging, and …
https://www.osc.ny.gov/state-agencies/audits/2020/04/02/low-income-housing-trust-fund-program-followMonitoring and Administration of Public Protection Grant Programs
… justice system. To that end, the Division administers State and federal grant programs aimed at crime prevention … as aggravated assault, forcible rape, and robbery – in the State, excluding New York City. GIVE contracts may include … in Division public protection program funding for the State Fiscal Year ended March 31, 2020 to entities such as …
https://www.osc.ny.gov/state-agencies/audits/2020/04/24/monitoring-and-administration-public-protection-grant-programsExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… Objective To assess the extent of implementation of the four recommendations included in our initial audit … moved to Medicaid fee-for-service (FFS) because the cost of the managed care premiums generally exceeds the cost of … To assess the extent of implementation of the four recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… ). About the Program Hospice is a coordinated program of home and/or inpatient care that treats terminally ill … physician, and counseling services; home health aides; physical and occupational therapy; medical appliances and supplies; and drugs. When …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followImproper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)
… 2021, was to determine if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in the … Program eligibility determinations and prevent improper premium payments. We found that Medicaid made $31.7 million in improper Medicare premium payments for individuals who did not have a benefit …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/improper-payments-medicare-buy-premiums-ineligible-recipients-followImproper Medicaid Managed Care Payments for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies on Behalf of Recipients in Nursing Homes (Follow-Up)
… medical use such as gauze and wipes. Medicaid nursing home reimbursement rates generally include the cost of most …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/improper-medicaid-managed-care-payments-durable-medical-equipment-prosthetics-orthotics-andImplementation 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 …
https://www.osc.ny.gov/state-agencies/audits/2023/09/29/implementation-security-guard-act-followImproper Payments for Services Related to Ordering, Prescribing, Referring, or Attending Providers No Longer Participating in the Medicaid Program (Follow-Up)
… Act and implementing federal regulations mandated that State Medicaid agencies require all ordering and referring … program to be enrolled as participating providers in the State Medicaid program. Accordingly, beginning January 1, … improper payments for claims in violation of federal and State requirements related to OPRA providers who were no …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/improper-payments-services-related-ordering-prescribing-referring-or-attending-providers-no