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United HealthCare – Empire Plan Drug Rebate Revenue (Follow-Up)
… Purpose To determine the implementation status of the recommendation made in our audit report, United … To determine the implementation status of the recommendation made in our audit report United …
https://www.osc.ny.gov/state-agencies/audits/2017/05/15/united-healthcare-empire-plan-drug-rebate-revenue-followMedicaid Program – Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus
… Purpose To determine whether the Department of Health (Department) made inappropriate premium payments to Medicaid mainstream managed care plans and Family Health Plus managed care plans (Plans) for recipients who … To determine whether the Department of Health made inappropriate premium payments to Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/medicaid-program-inappropriate-premium-payments-recipients-no-longer-enrolled-mainstreamThe 80/20 Housing Program
… provides income tax credits, and municipalities provide real estate tax abatements, as incentives to developers. In New … as 50 percent of an Area’s Median Income (AMI) adjusted for household size. For a New York City family of four, the …
https://www.osc.ny.gov/state-agencies/audits/2017/05/31/8020-housing-programWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… the State Education Department’s (SED) Reimbursable Cost Manual (Manual). The audit included all expenses claimed for the … $154,563 in reported costs that did not comply with Manual requirements and recommend such costs be disallowed. …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualNursing Home Surveillance
… State regulations and procedures for conducting nursing home surveys and whether survey processes, including the … Complaint surveys investigate issues, and nursing home-reported incidents, that may involve non-compliance with … for severity and urgency to assess whether a nursing home has violated a federal or State regulation. If any …
https://www.osc.ny.gov/state-agencies/audits/2016/02/19/nursing-home-surveillancePractices Used by the Transit Adjudication Bureau to Collect and Account for Fines and Fees
… Purpose To determine whether the Transit Adjudication Bureau of New York City Transit performs its responsibilities in an effective and … January 1, 2013 to December 31, 2015. Background The Transit Adjudication Bureau (TAB) is an administrative … To determine whether the Transit Adjudication Bureau of New York City Transit performs …
https://www.osc.ny.gov/state-agencies/audits/2016/08/11/practices-used-transit-adjudication-bureau-collect-and-account-fines-and-feesSelect Financial Management Practices
… Purpose To determine if the Albany Port District Commission’s (Commission) capital planning process and collection and … delinquent accounts receivable are in compliance with the Commission’s procedures for the period January 1, 2013 … To determine if the Albany Port District Commissions Commission capital planning process and collection and …
https://www.osc.ny.gov/state-agencies/audits/2015/11/05/select-financial-management-practicesMedicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… enrolled recipients. The Department uses encounter data for numerous purposes, including, but not limited to, quality … research and analytics, managed care rate setting, and drug rebate collections. On September 14, 2015, the … DOH did not provide any additional time or special assistance to the less sophisticated plans; all plans were …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemDriver Responsibility Assessment Program
… secure identity documents, to deliver essential motor vehicle and driver-related services, and to administer motor vehicle laws enacted to promote safety and protect consumers. … in November 2004, the State Legislature amended the Vehicle and Traffic Law (Law) establishing the Driver …
https://www.osc.ny.gov/state-agencies/audits/2014/10/09/driver-responsibility-assessment-programFinancial Management Practices
… Purpose To determine if the Hudson River-Black River Regulating … regulates the flow of the Hudson River and the Black River to reduce flooding caused by excess run-off and to augment river flow at times of drought. Organized as a … To determine if the Hudson RiverBlack River Regulating …
https://www.osc.ny.gov/state-agencies/audits/2014/11/25/financial-management-practicesMedicaid Program – Medicaid Claims Processing Activity October 1, 2014 Through March 31, 2015
… Purpose To determine whether the Department of Health’s eMedNY system reasonably ensured that … October 1, 2014 through March 31, 2015. Background The Department of Health (Department) administers the State’s Medicaid program. The … Determine whether Department of Healths eMedNY system reasonably ensured that …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-program-medicaid-claims-processing-activity-october-1-2014-through-march-31-2015Tuition Assistance Program – Metropolitan Learning Institute
… awards and other State financial aid. Background TAP is an entitlement program designed to provide funds for … The Metropolitan Learning Institute (Metropolitan) is a licensed private career school headquartered in Rego …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/tuition-assistance-program-metropolitan-learning-instituteFuel Purchases
… provide public transportation services in Monroe, Genesee, Livingston, Orleans, Wayne, Wyoming, and Seneca counties. …
https://www.osc.ny.gov/state-agencies/audits/2015/02/27/fuel-purchasesAccountability for Traffic Ticket Surcharges
… collected, accounted for, and reported all traffic ticket surcharge revenue received through its Traffic … for processing and collecting fines and traffic ticket surcharges. Unlike fines, surcharges are … TVBs, including about $147 million generated from traffic ticket surcharges. Key Findings With the exception of about …
https://www.osc.ny.gov/state-agencies/audits/2015/08/10/accountability-traffic-ticket-surchargesMedicaid Program – Payments for Death-Related One-Day Inpatient Admissions
… methodology used to compensate hospitals for inpatient medical care. The new methodology, based on All Patient … factor. Because patient deaths can result from more severe medical conditions, Medicaid payments for death-related … a 'short stay' except for certain patient transfers and specialty hospitals. By modifying the APR DRG-based …
https://www.osc.ny.gov/state-agencies/audits/2013/08/15/medicaid-program-payments-death-related-one-day-inpatient-admissionsDual Employment
… Purpose To determine whether Department of Corrections and Community Supervision (DOCCS) employees who are dually … 2013. Background DOCCS is responsible for the confinement and habilitation of approximately 56,000 offenders at 60 … allows employees to work full-time at one facility and then work additional time at another facility (referred …
https://www.osc.ny.gov/state-agencies/audits/2013/12/19/dual-employment-2Medicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… services refer to health care services provided in the home, medical offices, clinics, and other freestanding sites. … to Department officials for review. Medicaid reimbursement rates for inpatient hospital claims include the costs of most … of related payments. Other Related Audits/Reports of Interest Department of Health: Overpayments of Ambulatory …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… Purpose To determine whether mainstream managed care organizations (MCOs) are submitting accurate … costs to the Department of Health (Department) and whether the Department is appropriately applying the administrative costs in determining mainstream managed care premium rates. Our audit covered the period January 1, …
https://www.osc.ny.gov/state-agencies/audits/2016/10/13/medicaid-program-mainstream-managed-care-organizations-administrative-costs-used-premiumInmate Sentence Calculation and Release Practices
… Purpose To determine whether the Department of Corrections and Community Supervision … within 19 days. Other Related Audit/Report of Interest Department of Corrections and Community Supervision: … To determine whether the Department of Corrections and Community Supervision …
https://www.osc.ny.gov/state-agencies/audits/2017/04/07/inmate-sentence-calculation-and-release-practicesEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… and recovery of overpayments made to hospitals for special medical items; and took sufficient steps to … many of Empire’s member hospitals limit payment amounts for special items; however, some contracts do not have … year audit period, Empire paid the hospitals $636 million for special items. From 2009 through 2012, the Office of the …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-items