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Milestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the Milestone School for Child Development (Milestone) on its … documented, program related, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost … Determine whether the costs reported by Milestone School for Child Development …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualAdministration of the Contract With the Center for Urban Community Services
… Purpose We audited the New York City Department of Health and Mental Hygiene’s … increased to $28.7 million for expanded program services. The New York State Office of Mental Health funds about 75 … We audited the New York City Department of Health and Mental Hygienes …
https://www.osc.ny.gov/state-agencies/audits/2016/02/16/administration-contract-center-urban-community-servicesMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… two separate payments are made: a payment for the first hospital’s claim and a payment for the second hospital’s claim. However, according to the Department’s … when a recipient is transferred from the first hospital to a merged or consolidated division or hospital, …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilitiesMedicaid Program – Overpayments of Hospitals' Claims for Lengthy Acute Care Admissions
… levels of medical care than those actually provided to patients. The audit covers the period April 1, 2005 through … 297 hospital stays that were billed by ten hospitals for patients admitted for 50 or more days for high levels of care … Medicaid for days in acute care settings when, in fact, patients received lower cost ALC. In one case, Medicaid paid …
https://www.osc.ny.gov/state-agencies/audits/2013/07/25/medicaid-program-overpayments-hospitals-claims-lengthy-acute-care-admissionsAll Services for Kids, Inc. – Compliance With the Reimbursable Cost Manual
… service expenses, including inappropriately allocated rental expenses, cell phones used by the Executive Director's minor children, unaccounted-for equipment items, and cable television. Key Recommendation SED …
https://www.osc.ny.gov/state-agencies/audits/2014/02/25/all-services-kids-inc-compliance-reimbursable-cost-manualMedicaid Program – Improper Payments of Medicare Buy-in Premiums for Ineligible Recipients
… if Medicaid made improper Medicare premium payments on behalf of recipients enrolled in the Medicare buy-in … should not pay premiums for Buy-in Program coverage on behalf of individuals who do not have a benefit … made $31.7 million in improper Medicare premium payments on behalf of 42,586 individuals who did not have a benefit …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-payments-medicare-buy-premiums-ineligible-recipientsOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… Objective To assess the extent of implementation of the three … Medicaid program provides a wide range of medical services to those who are economically disadvantaged and/or have … also enrolled in Medicare. Such individuals are referred to as “dual-eligibles.” The Medicare program covers physical, …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… To determine whether Empire BlueCross properly paid hospital claims for intraocular procedures. The audit covered … million members. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsManaged Care Premium Payments for Recipients With Comprehensive Third-Party Insurance (Follow-Up)
… Payments for Recipients With Comprehensive Third-Party Insurance (Report 2016-S-60 ). About the Program … care when they also have comprehensive TPHI. Recipients should, instead, be enrolled in Medicaid fee-for-service to avoid the expense of monthly managed care premiums (for instance, under fee-for-service, after the …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/managed-care-premium-payments-recipients-comprehensive-third-party-insurance-followOpioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program (Follow-Up)
… Objective To determine the extent of implementation of the three … an opioid use disorder. The State maintains a database to monitor controlled substance prescription drug use, known … of controlled substance prescriptions. I-STOP is a tool to assist prescribers in determining the most appropriate …
https://www.osc.ny.gov/state-agencies/audits/2020/05/07/opioid-prescriptions-medicaid-recipients-opioid-treatment-program-followMedicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY (Follow-Up)
… Objective To determine the extent of implementation of the five … Overpayments for Medicare Part B Services Billed Directly to eMedNY (Report 2017-S-36 ). About the Program The … To determine the extent of implementation of the five …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-part-b-services-billed-directly-emedny-followMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement
… Objective To determine whether Medicaid inappropriately paid for drugs … program. The Medicaid Drug Rebate Program (MDRP) helps to offset the costs of most covered outpatient drugs dispensed to Medicaid patients. The MDRP requires drug manufacturers to … To determine whether Medicaid inappropriately paid for drugs …
https://www.osc.ny.gov/state-agencies/audits/2024/02/23/medicaid-program-improper-payments-drugs-without-federal-drug-rebate-agreementCompliance With Special Education Regulations for the Provision of Services (Follow-Up)
… Objective To determine the extent of implementation of the five … providing special education and related services designed to meet students’ unique needs and to prepare them for further education, employment, and … To determine the extent of implementation of the five …
https://www.osc.ny.gov/state-agencies/audits/2023/03/15/compliance-special-education-regulations-provision-services-followMedicaid Program – Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition
To determine whether Medicaid made overpayments to hospitals that improperly billed All Patient Refined Diagnosis Related Groups inpatient claims containing a severe malnutrition diagnosis
https://www.osc.ny.gov/state-agencies/audits/2019/04/08/medicaid-program-improper-medicaid-payments-recipients-diagnosed-severe-malnutritionNorthside Center for Child Development – Compliance With the Reimbursable Cost Manual
… Class (SC) and full-day Preschool Special Class in an Integrated Setting (SCIS) to children with disabilities who … These ineligible costs included $152,373 in personal service costs and $117,667 in other than personal service costs. Among the ineligible costs identified were: …
https://www.osc.ny.gov/state-agencies/audits/2019/01/11/northside-center-child-development-compliance-reimbursable-cost-manualMedicaid Program – Improper Fee-for-Service Payments for Services Covered by Managed Care
… a child born to a mother enrolled in a Plan should be enrolled in the mother’s Plan from the month of birth. … track or penalize lateness when hospitals do not report live births within five business days to the Department. The …
https://www.osc.ny.gov/state-agencies/audits/2019/01/10/medicaid-program-improper-fee-service-payments-services-covered-managed-careMedicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (Follow-Up)
… Purpose To determine the extent of implementation of the four … in the Medicaid program dispense prescription drugs to Medicaid beneficiaries. During the period January 1, 2008 … recipients. One particular doctor (herein referred to as “the Doctor”) was listed as the prescriber on 31,351 …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriber-followGASB Statement No. 33 "Accounting and Financial Reporting for Nonexchange Transactions"
… GASB Statement No. 33 provides accounting and reporting guidelines for nonexchange transactions. A nonexchange … GASB Statement No 33 provides accounting and reporting guidelines for nonexchange transactions …
https://www.osc.ny.gov/local-government/publications/gasb-statement-no-33-accounting-and-financial-reporting-nonexchange-transactionsCity of Batavia – Awarding Contracts for Goods and Services (2013M-296)
… Purpose of Audit The purpose of our audit was to review the City’s purchasing process for … 1, 2012 through September 6, 2013. Background The City of Batavia is located in Genesee County and has a population … City of Batavia Awarding Contracts for Goods and Services 2013M296 …
https://www.osc.ny.gov/local-government/audits/city/2014/01/24/city-batavia-awarding-contracts-goods-and-services-2013m-296Revenue Enhancement Ideas: Cash Management for Local Governments and School Districts
… financial management information system or online banking to track daily cash balances. Perform a detailed cash flow … timing when formulating the budget. Review historical data to determine typical cash inflows and outflows throughout the … the frequency of billing (for example, from semiannual to quarterly), but first perform an analysis to ensure that …
https://www.osc.ny.gov/local-government/publications/revenue-enhancement-ideas-cash-management-local-governments-and-school-districts