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Overpayments of Certain Medicare Crossover Claims (Follow-Up)
… made in our audit report, Overpayments of Certain Medicare Crossover Claims (2011-S-28). Background Many Medicaid recipients are also enrolled in Medicare, the federal health care program for people 65 years … programs are referred to as “dual-eligibles.” Generally, Medicare is the primary payer for medical services provided …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followMedicaid Payments for Excessive Dental Services (Follow-Up)
… included in our initial audit report, Medicaid Payments for Excessive Dental Services (Report 2009-S-46). Background … issued on August 16, 2010, examined Medicaid payments for routine dental services, such as cleanings and oral … that if the Department adjusted its Medicaid fees for these services to the averages of other comparable …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/medicaid-payments-excessive-dental-services-followContract with EBSCO Subscription Services, Inc. (Follow-Up)
… is the largest provider in this contract group. Its current five-year contract is valued at $140 million and … examined billings to one agency, the State University of New York, and found EBSCO was billing in excess of the $35 … in our initial audit, along with an additional $445,000 to cover similar estimated overcharges to all State agencies …
https://www.osc.ny.gov/state-agencies/audits/2013/05/13/contract-ebsco-subscription-services-inc-followQuality of Internal Control Certification
… (Division) submitted timely a quality Internal Control Certification to the Division of Budget (DOB) by April 30, … Control Act by April 30 of each year by submitting a certification and internal control summary detailing the … 2012, the Division submitted its annual Internal Control Certification and reported full compliance with all but one …
https://www.osc.ny.gov/state-agencies/audits/2013/05/09/quality-internal-control-certificationReporting and Utilization of Bias Incident Data
… To determine whether the New York City Police Department NYPD is accurately collecting recording and …
https://www.osc.ny.gov/state-agencies/audits/2014/09/25/reporting-and-utilization-bias-incident-dataMedicaid Payments for Medicare Part A Beneficiaries (Follow-Up)
… made in our audit report, Medicaid Payments for Medicare Part A Beneficiaries (2009-S-36). Background Our … 20, 2010, examined whether Medicaid made overpayments for recipients who were also enrolled in Medicare Part A. … Medicare Part A provides supplementary medical insurance for inpatient care in hospitals, post-hospital nursing home …
https://www.osc.ny.gov/state-agencies/audits/2014/04/04/medicaid-payments-medicare-part-beneficiaries-followNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… initial report Group Health Incorporated: New York State Dental Program - Payments for Scaling and Root Planing … 1, 2005 through December 31, 2008. New York State provides dental insurance benefits to certain State employees and … contracts with Group Health Incorporated (GHI) to process dental claims on behalf of the State. Emblem Health is the …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… our initial audit report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of … adjudicates a claim, Medicaid pays the balance that is not covered by Medicare and would otherwise be the financial … generally would pay deductibles and coinsurance not covered by Medicare. Our initial audit report, which was …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followManagement of General School Funds (Follow-Up)
… John F. Kennedy Educational Campus: Management of General School Funds (Report 2009-N-11). Background Our initial … Campus staff with adequate oversight and training and that school officials did not exercise due diligence and care over General School Fund (GSF) accounts. We could not fully account for …
https://www.osc.ny.gov/state-agencies/audits/2014/09/30/management-general-school-funds-followVehicle and Heavy Equipment Purchase Program (Follow-Up)
… in its annual Purchase Program. We also found that the car service contract amounts were excessive compared to the …
https://www.osc.ny.gov/state-agencies/audits/2014/11/03/vehicle-and-heavy-equipment-purchase-program-followManagement and Control of Employee Overtime Costs (Follow-Up)
… in excess of $75,000 annually by individuals whose salary base was at least $75,000. We also found overtime … requiring its departments not to exceed 15 percent of base salaries was not met. Key Finding The Port Authority …
https://www.osc.ny.gov/state-agencies/audits/2014/12/19/management-and-control-employee-overtime-costs-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… Payments for Certain Medicaid Recipients (Report 2010-S-66). Background Our initial audit report, which was issued on … Care Payments for Certain Medicaid Recipients ( 2010-S-66 ) …
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followAmerican Academy of Pediatrics, District II
… Purpose In conjunction with our Investigations Unit, we examined … to determine whether the expenses were bona fide and made in accordance with the contracts. Background During the … Assistant, and wages reportedly paid to the AAP webmaster. In six instances, the Executive Director submitted false …
https://www.osc.ny.gov/state-agencies/audits/2014/02/28/american-academy-pediatrics-district-iiEnhanced Medicaid Payments to Selected Home Health Care Service Providers (Follow-Up)
… Purpose To determine the extent of implementation of the four … in our initial audit report, Enhanced Medicaid Payments to Selected Home Health Care Service Providers (Report 2009-S-25). … To determine the extent of implementation of the four …
https://www.osc.ny.gov/state-agencies/audits/2013/09/05/enhanced-medicaid-payments-selected-home-health-care-service-providers-followOverpayments of Claims for Selected Professional Services (Follow-Up)
… the calendar years 2010 and 2011. In each case, both the provider and the provider's affiliated medical group received Medicaid … claim contained a different provider identification number. We recommended the Department correct the flaw in the …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followChemical Dependency Program Payments to Selected Contractors in New York City (Follow-Up)
… the payments to two contractors; Palladia Inc, and the Queens Child Guidance Center by the Office of Alcoholism and …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/chemical-dependency-program-payments-selected-contractors-new-york-city-follow2014 Year End Report
… Fund, the Special Fund for Disability Benefits, the Second Injury Fund, and the Fund for Reopened Cases.The Board … (Triad) under contract C-140311. Claims from the Second Injury Fund are processed by the Special Funds Conservation … If either the Board or our Office rejects a Triad claim, the reimbursement is denied. Triad is then responsible …
https://www.osc.ny.gov/state-agencies/audits/2015/03/30/2014-year-end-reportExamination of Unemployment Insurance Benefits
… high risk payment requests and payments DOL processed from January 1, 2014 through December 31, 2014, prior years’ … recoveries totaling $403,456. This includes $224,220 from newly hired New York State employees who owe DOL for UI overpayments made in prior years, and $179,236 from claimants against whom DOL assessed monetary penalties …
https://www.osc.ny.gov/state-agencies/audits/2015/10/07/examination-unemployment-insurance-benefitsFood Safety Monitoring
… monitors the processing, distribution and sale of food products in New York State. The audit covers the period April … monitors the processing distribution and sale of food products in New Yo …
https://www.osc.ny.gov/state-agencies/audits/2014/01/30/food-safety-monitoringSelected Aspects of Bus Fleet Maintenance Report (Follow-Up)
… included in our initial audit report, Selected Aspects of Bus Fleet Maintenance (Report 2009-S-51). Background Our … has standards and procedures for the maintenance of its bus fleet, (2) performs bus maintenance in compliance with these standards and … included in our initial audit report Selected Aspects of Bus Fleet Maintenance Report 2009 …
https://www.osc.ny.gov/state-agencies/audits/2013/07/11/selected-aspects-bus-fleet-maintenance-report-follow