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Overpayments of Certain Medicare Crossover Claims
… Purpose To determine if Medicaid overpaid Medicare crossover claims for physician and other outpatient services and to identify the claims processing control weaknesses that … To determine if Medicaid overpaid Medicare crossover claims …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/overpayments-certain-medicare-crossover-claimsRiverbank State Park – Administration of the Concession Contract With Riverbank Restaurant Group
… Park operated by Riverbank Restaurant Group, LLC (RRG), for the period May 1, 2004 to December 31, 2013. The … of Manhattan, is open 365 days a year and has a variety of indoor and outdoor athletic and cultural facilities. In March 2004, …
https://www.osc.ny.gov/state-agencies/audits/2014/11/24/riverbank-state-park-administration-concession-contract-riverbank-restaurant-groupAffordable Home Ownership Development Program
… Purpose To determine whether Affordable Home Ownership Development Program (Program) grant managers are awarding grant monies to existing and … Grant monies may be used for new construction, home improvements, or acquisition and repair projects. The … To determine whether Affordable Home Ownership Development Program Program grant managers are …
https://www.osc.ny.gov/state-agencies/audits/2014/10/06/affordable-home-ownership-development-programInstitutes of Applied Human Dynamics – Compliance With the Reimbursable Cost Manual
… costs reported on the Consolidated Fiscal Reports (CFRs) of the Institutes of Applied Human Dynamics were calculated properly, … years ended June 30, 2012. Background The Institutes of Applied Human Dynamics, Inc. (Institutes) is a … the costs reported on the Consolidated Fiscal Reports CFRs of the Institutes of Applied Human Dynamics were calculated …
https://www.osc.ny.gov/state-agencies/audits/2014/12/31/institutes-applied-human-dynamics-compliance-reimbursable-cost-manualExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… Payments for Services to Recipients Receiving Medicare Benefits (Report 2009-S-64). Background Our initial audit … been avoided had the Department taken more comprehensive and proactive steps to administer Medicaid reimbursements for … efforts to limit Medicaid payments in areas where Medicaid and Medicare programs overlap. The remaining $100 million in …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followOverpayments of Hospitals’ Claims for Lengthy Acute Care Admissions (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations made in our audit report, Overpayments of Hospitals’ Claims for Lengthy Acute Care Admissions … To determine the extent of implementation of the three recommendations made in our audit report …
https://www.osc.ny.gov/state-agencies/audits/2015/07/07/overpayments-hospitals-claims-lengthy-acute-care-admissions-followTuition Assistance Program – Metropolitan College of New York
… Purpose To determine whether Metropolitan College of New York complied with the Education Law and the Commissioner of Education’s Rules and Regulations when certifying students … for State financial aid. Background Metropolitan College of New York (Metropolitan) operates at two locations, …
https://www.osc.ny.gov/state-agencies/audits/2016/07/25/tuition-assistance-program-metropolitan-college-new-yorkLeague for the Handicapped – Compliance With the Reimbursable Cost Manual
… LFH, a not-for-profit organization located in Springville, New York, is an SED-approved provider of special education … 35 school districts located in three counties in western New York. The counties that use LFH’s special education …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/league-handicapped-compliance-reimbursable-cost-manualNewmeadow, Inc. – Compliance With the Reimbursable Cost Manual
… Newmeadow, a not-for-profit organization located in Malta, New York, provides preschool special education … reported costs must comply with the guidelines specified in the RCM. For the fiscal year ended June 30, 2014, Newmeadow reported $2.9 million in reimbursable costs on its CFR for its preschool special …
https://www.osc.ny.gov/state-agencies/audits/2015/12/29/newmeadow-inc-compliance-reimbursable-cost-manualUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in … Background Our initial audit report, which was issued on August 13, 2013, determined that, for the period January 1, 2008 through … Determine extent of implementation of 3 recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyProcurement and Contracting Practices (Follow-Up)
… whether the procurement and contracting practices of the New York State Office of Information Technology Services (ITS), formerly known as the New York State Office for Technology, resulted in the best … the highest levels of the agency, that disregarded the New York State Finance Law, the State's Procurement …
https://www.osc.ny.gov/state-agencies/audits/2014/04/16/procurement-and-contracting-practices-followAdministration of the Article 8-A Loan Program
… of Housing Preservation and Development (HPD) under the Article 8-A Program are being used only for qualified … years ended June 30, 2012. Background HPD administers the Article 8-A Loan Program (Program), which provides low … of Housing Preservation and Development HPD under the Article 8A Program are being used …
https://www.osc.ny.gov/state-agencies/audits/2014/09/18/administration-article-8-loan-programUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… in Medicaid. For these children, the State establishes a “Daily Child Care Rate” (Daily Rate), which is the basis for Medicaid funding that the … children in their custody. For services not covered by the Daily Rate, health care providers bill Medicaid directly and …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… 1, 2011 Through June 30, 2011 (2011-S-42). Background The New York State Health Insurance Program (NYSHIP) provides … in this report. Other Related Audit/Report of Interest New York State Health Insurance Program: Empire BlueCross …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… manner, in some cases taking more than six months to enter new enrollee eligibility data. Key Recommendations Review the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careCancer Service Network, Inc.
… Purpose The objective of our examination was to determine whether contract payments the Department of … We found Mr. Joseph Junkovic knowingly overbilled DOH and was paid $397,325. This overbilling included: (i) $73,568 for … with the US Attorney, on August 14, 2013, Mr. Junkovic was arrested for one count of mail fraud and one count of …
https://www.osc.ny.gov/state-agencies/audits/2014/09/24/cancer-service-network-incHate Crime Reporting
… Justice Services (Division) adequately monitors hate crime reporting and takes steps to ensure complete and … city, and local police agencies (agencies) to report crime data, including hate crimes, to the Division. Crimes … practice, age, disability, or sexual orientation. Hate crime incidents that agencies report to the Division include …
https://www.osc.ny.gov/state-agencies/audits/2014/09/25/hate-crime-reportingJohn A. Coleman School – Compliance With the Reimbursable Cost Manual
… 491 students. The New York City Department of Education (DoE) and other school districts pay tuition and fees to … presents in an annual CFR filed with SED. SED reimburses DoE and the other school districts for a portion of their …
https://www.osc.ny.gov/state-agencies/audits/2013/08/05/john-coleman-school-compliance-reimbursable-cost-manualThe Norman Howard School – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether costs reported by the Norman Howard … Rochester, New York, provides special education services to children with learning disabilities in grades 5 through … files with the New York State Education Department (SED). To be eligible for reimbursement, the expenses must comply …
https://www.osc.ny.gov/state-agencies/audits/2013/07/15/norman-howard-school-compliance-reimbursable-cost-manualRochester Childfirst Network – Compliance With the Reimbursable Cost Manual
… Preschool Integrated Special Class services to 56 children with learning disabilities from ten school districts in … be eligible for reimbursement, reported costs must comply with the guidelines in the Manual. For the fiscal year ended … preschool special education programs that did not comply with the Manual’s requirements for reimbursement. The …
https://www.osc.ny.gov/state-agencies/audits/2016/11/17/rochester-childfirst-network-compliance-reimbursable-cost-manual