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Medicaid Program – Medicaid Claims Processing Activity October 1, 2016 Through March 31, 2017
… Purpose To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … 1, 2016 through March 31, 2017. Background The Department of Health (Department) administers the State’s Medicaid … 192 million claims, resulting in payments to providers of more than $29 billion. The claims are processed and paid …
https://www.osc.ny.gov/state-agencies/audits/2017/12/08/medicaid-program-medicaid-claims-processing-activity-october-1-2016-through-march-31-2017Optimizing Medicaid Drug Rebates (Follow-Up)
… Purpose To determine the implementation status of the five recommendations made in our initial audit report, … The State’s Medicaid program provides a wide range of health care services to individuals who are economically … January 1991, New York has been able to recover a portion of the Medicaid prescription drug costs by requesting rebates …
https://www.osc.ny.gov/state-agencies/audits/2017/12/20/optimizing-medicaid-drug-rebates-followMedicaid Program – Medicaid Claims Processing Activity April 1, 2017 Through September 30, 2017
… Purpose To determine whether the Department of Health's eMedNY system reasonably ensured that Medicaid … 2017 through September 30, 2017. Background The Department of Health (Department) administers the State’s Medicaid … 193 million claims, resulting in payments to providers of more than $31 billion. The claims are processed and paid …
https://www.osc.ny.gov/state-agencies/audits/2018/08/03/medicaid-program-medicaid-claims-processing-activity-april-1-2017-through-september-30-2017Medicaid Program – Maximizing Drug Rebates for Health and Recovery Plans
… Purpose To determine whether the Department of Health took appropriate steps to collect all available … drug manufacturers. On a quarterly basis, the Department of Health (Department) submits rebate invoices to the … drug rebates to cover medications dispensed to enrollees of Medicaid managed care organizations (MCOs). As a result of …
https://www.osc.ny.gov/state-agencies/audits/2018/06/22/medicaid-program-maximizing-drug-rebates-health-and-recovery-plansUnited HealthCare – Empire Plan Drug Rebate Revenue (Follow-Up)
… Purpose To determine the implementation status of the recommendation made in our audit report, United … about 1.1 million members. The New York State Department of Civil Service (Department) contracted with United … discounts, and other considerations and pass 100 percent of the value of the agreements on to the Department. Our …
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 … In return, managed care plans arrange for the provision of health care services their members require. The State’s Medicaid program offers different types of managed care. Most Medicaid recipients are enrolled in …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/medicaid-program-inappropriate-premium-payments-recipients-no-longer-enrolled-mainstreamPractices Used by the Transit Adjudication Bureau to Collect and Account for Fines and Fees
… To determine whether the Transit Adjudication Bureau of New York City Transit performs its responsibilities in an … for processing and adjudicating summonses for violations of NYC Transit (Transit) rules governing public use of the transit system. TAB offers a respondent the …
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
… capital planning process and collection and reporting of delinquent accounts receivable are in compliance with the … In 1925, the Commission was established through an act of the New York State Legislature. The enabling legislation … and effectively manage the publicly owned maritime Port of Albany-Rensselaer, contributing to the economy of the …
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
… Purpose To determine the readiness of all Medicaid managed care organizations (MCOs) to submit … Encounter Intake System. We conducted an early assessment of the readiness of Medicaid MCOs as of September 30, 2015. We did not review … To determine the readiness of all Medicaid managed care organizations to submit Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemDriver Responsibility Assessment Program
… Purpose To determine whether the Department of Motor Vehicles (Department) has accurately assessed and … the licenses, or the privilege to obtain a license, of drivers who did not pay their assessed fees. Our audit … consumers. In an effort to prevent the repeated behavior of problem drivers and to improve traffic safety, in November …
https://www.osc.ny.gov/state-agencies/audits/2014/10/09/driver-responsibility-assessment-programFinancial Management Practices
… (District) financial management practices in the areas of revenue collection, payroll, procurement, asset and … March 15, 2014. Background The District regulates the flow of the Hudson River and the Black River to reduce flooding … by excess run-off and to augment river flow at times of drought. Organized as a public benefit corporation, it has …
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 Medicaid … 1, 2014 through March 31, 2015. Background The Department of Health (Department) administers the State’s Medicaid … 264 million claims, resulting in payments to providers of about $28.5 billion. The claims are processed and paid in …
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
… complied with the Education Law and the Commissioner of Education’s Rules and Regulations when certifying students … totaling almost $8.7 million that were paid on behalf of 1,890 students. At the time of our audit, Metropolitan served about 550 students. Tuition …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/tuition-assistance-program-metropolitan-learning-instituteAccountability for Traffic Ticket Surcharges
… Purpose To determine whether the Department of Motor Vehicles (Department) accurately assessed, … and Traffic Law authorizes cities with a population of 200,000 or more to adjudicate non-criminal traffic … non-negotiable costs – preset based on the type and date of violation – that cannot be waived. However, the Vehicle …
https://www.osc.ny.gov/state-agencies/audits/2015/08/10/accountability-traffic-ticket-surchargesMedicaid Program – Payments for Death-Related One-Day Inpatient Admissions
… Purpose To determine whether the Department of Health (Department) appropriately and effectively … Medicaid services when patient deaths occur within one day of admission. The audit covers the period December 1, 2009 … patient treatment. Key Findings Since the implementation of the APR DRG-based methodology, Medicaid has paid …
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) … DOCCS is responsible for the confinement and habilitation of approximately 56,000 offenders at 60 facilities across the State. As of September 1, 2012, DOCCS had 29,796 employees. To ensure …
https://www.osc.ny.gov/state-agencies/audits/2013/12/19/dual-employment-2Inmate Sentence Calculation and Release Practices
… Purpose To determine whether the Department of Corrections and Community Supervision (Department) follows … sentences to ensure accurate and consistent calculation of sentence times in accordance with all laws and … and regulations regarding the sentencing and incarceration of inmates in New York State, including Penal Law Section …
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
… sufficient controls over the identification and recovery of overpayments made to hospitals for special medical items; … and took sufficient steps to minimize the State’s risk of excessive payments which result from contracts with … that do not include language that limits the reimbursement of special medical items. The audit covered the period …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsCompliance With Navigation Law
… Objective To determine if the Office of Parks, Recreation and Historic Preservation (Parks) is … requirements to ensure boaters’ safety and quality of life on State waters in accordance with New York State … October 31, 2019. About the Program With its vast network of waterways, including about 70,000 miles of rivers and …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/compliance-navigation-lawWelcome Center and Rest Area Planning and Implementation
… Objective To determine if the Department of Transportation (Department) has a written capital plan for … through May 22, 2018. About the Program It is the mission of the Department to ensure its customers – those who live, … Projects – with Safety being the overarching theme for all of the principles. The capital program includes projects to …
https://www.osc.ny.gov/state-agencies/audits/2019/06/20/welcome-center-and-rest-area-planning-and-implementation