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UnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services
… of Civil Service (Civil Service) administers NYSHIP. In carrying out its responsibilities, Civil Service contracts … bill. The amount of United’s reimbursement depends on the level of care billed – the higher the level billed, … E/M services. Key Findings Improvements are needed in United’s method for monitoring out-of-network providers …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesNew York State Health Insurance Program - Empire Plan Members With Dual Family Coverage
… also allows for the inclusion of other public employees in New York, including those of local government entities … if a member and their spouse are both eligible to enroll in NYSHIP, only one may elect Family coverage (the other may … have information to determine if a member is a dependent on another NYSHIP policy with the State or a different …
https://www.osc.ny.gov/state-agencies/audits/2021/01/07/new-york-state-health-insurance-program-empire-plan-members-dual-family-coverageState Agencies Bulletin No. 560
… that overtime compensation is paid only for work in excess of the basic 40-hour work week. An employee eligible for Recall Overtime may or may not be on Standby. An employee who is on Standby and is recalled to … Standby pay for each eight (8) hours or part thereof in addition to any Recall pay. Hours paid pursuant to the …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/560-review-and-update-recall-overtime-pay-eligible-employees-classified-andEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012
… Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … Payments for hospital services are generally based on standard fee schedules. However, hospitals may be entitled … above the amount Empire should have paid for the items in question. For one hospital, Empire paid $68,382 for three …
https://www.osc.ny.gov/state-agencies/audits/2013/12/13/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughState Agencies Bulletin No. 2227
… Purpose: As we prepare for enactment of the 2024-25 NYS budget, OSC would like to provide notice of … paid on either the Institution or Administration pay cycle may be affected. *This does not apply to employees … all other advices can be released. Background: If the SFY 2024-25 budget is not passed or a budget extender bill to …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2227-paycheck-distribution-and-release-direct-deposit-funds-preparationState Agencies Bulletin No. 2328
… Purpose: As we prepare for enactment of the 2025-26 NYS budget, OSC would like to provide notice of … of your email. … As we prepare for enactment of the 202526 NYS budget OSC would like to provide notice of the …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2328-paycheck-distribution-and-release-direct-deposit-funds-preparationOversight of the Supported Housing Program – Rehabilitation Support Services, Inc.
… illness, but are able to live independently rather than in a facility. Eligible individuals include those discharged … private hospitals, as well as other individuals currently in the community who need housing. Clients in the Program … measures it has established. RSS claimed expenses on its Consolidated Fiscal Report (CFR) that either are not …
https://www.osc.ny.gov/state-agencies/audits/2017/05/04/oversight-supported-housing-program-rehabilitation-support-services-incAkron Man Pleads Guilty to Stealing FEMA Grant Funding Intended for Education Expenses
… money. The charge carries a maximum penalty of 10 years in prison and a $250,000 fine. Assistant U.S. Attorney John D. Fabian, who is handling the case, stated that on January 12, 2015, the defendant deposited into his account … to Akron Mobile Home Park. "Mr. Lobur took nearly $40,000 in federal grant money meant to further the education of …
https://www.osc.ny.gov/press/releases/2019/07/akron-man-pleads-guilty-stealing-fema-grant-funding-intended-education-expensesOpinion 2002-3
… subsequent court cases or statutory amendments that bear on the issues discussed in the opinion. IMPROVEMENT DISTRICTS -- Dock Districts … districts. Subdivision 10 of section 198 provides, in pertinent part, that, except as otherwise provided by law, …
https://www.osc.ny.gov/legal-opinions/opinion-2002-3Village of South Corning – Clerk-Treasurer’s Records and Reports (2017M-114)
… 2017. Background The Village of South Corning is located in the Town of Corning in Steuben County and has a population of approximately … for an audit, of the Clerk-Treasurer’s records and reports on an annual basis. … Village of South Corning …
https://www.osc.ny.gov/local-government/audits/village/2017/11/17/village-south-corning-clerk-treasurers-records-and-reports-2017m-114Florida Union Free School District – Information Technology (2017M-146)
… information (PPSI) have not been developed. The District does not have service level agreements for services provided …
https://www.osc.ny.gov/local-government/audits/school-district/2017/11/03/florida-union-free-school-district-information-technology-2017m-146Quogue Union Free School District – Financial Condition Management (2017M-196)
… The Quogue Union Free School District is located in the Town of Southampton in Suffolk County. The District, which is governed by a Board … to the legal limit. Adopt realistic annual budgets based on historical or other known trends. Review the retirement …
https://www.osc.ny.gov/local-government/audits/school-district/2017/12/01/quogue-union-free-school-district-financial-condition-management-2017mCity of Watertown – Information Technology (2017M-184)
… safeguarded personal, private and sensitive information on City servers and in its financial system for the period July 1, 2015 through … April 5, 2017. Background The City of Watertown is located in Jefferson County and is governed by an elected five-member …
https://www.osc.ny.gov/local-government/audits/city/2017/12/01/city-watertown-information-technology-2017m-184City of Glen Cove – Financial Condition, Claims Processing and Payroll (2017M-210)
… 31, 2016. Background The City of Glen Cove is located in Nassau County and has a population of approximately … not adopted structurally balanced budgets, having relied on nonrecurring revenues, debt and interfund transfers to … operating revenues. Ensure interfund transfers are in compliance with the City’s charter and do not exceed fund …
https://www.osc.ny.gov/local-government/audits/city/2018/01/12/city-glen-cove-financial-condition-claims-processing-and-payroll-2017m-210Comptroller DiNapoli Releases School District Audits
… security policies and procedures to safeguard IT assets. In addition, employees stored personal data, such as photos, videos and music, on district computers. And district officials did not provide … 2018, the audit period. Three employees received $34,738 in health insurance buyouts that they may not have been …
https://www.osc.ny.gov/press/releases/2019/08/comptroller-dinapoli-releases-school-district-audits-0Town of Brownville Joint Fire District - Board Oversight (2018M-207)
… vendors to access the bank accounts. Except as specified in Appendix A, District officials generally agreed with our … corrective action. Appendix B includes our comment on an issue raised in the District’s response letter. … Determine whether the …
https://www.osc.ny.gov/local-government/audits/fire-district/2019/01/25/town-brownville-joint-fire-district-board-oversight-2018m-207Town of Ticonderoga – Financial Records and Reports (2015M-301)
… 30, 2015. Background The Town of Ticonderoga is located in Essex County and has a population of approximately 5,000. … accounting records did not agree with the amounts reported on its 2013 and 2014 Annual Update Documents (AUD). The Board … accurate, supported by the accounting records and filed in a timely manner. Provide the Board with monthly financial …
https://www.osc.ny.gov/local-government/audits/town/2016/02/26/town-ticonderoga-financial-records-and-reports-2015m-301Town of Berkshire – Procurement and Conflict of Interest (2023M-84)
… As a result, goods and services may not have been procured in a cost-effective manner. Of the 113 purchases totaling … reviewed. The Town may have saved $3,891 (6 percent) on diesel fuel purchases if Town officials had used the New … Superintendent (Superintendent) had a prohibited interest in a contract between the Town and his construction company, …
https://www.osc.ny.gov/local-government/audits/town/2023/12/08/town-berkshire-procurement-and-conflict-interest-2023m-84Ulster Board of Cooperative Educational Services – Network User Accounts (2023M-42)
… adequately managed and monitored network user accounts in order to help prevent unauthorized use, access and loss. … of inappropriate access by users with malicious intent. In addition to sensitive information technology (IT) control … accounts not used by active employees, that had last log on dates ranging from November 2016 to December 2021. Review …
https://www.osc.ny.gov/local-government/audits/boces/2023/08/18/ulster-board-cooperative-educational-services-network-user-accounts-2023m-42Brocton Central School District – Financial Management (2023M-44)
… with the statutory limit. Reduce overfunded reserves in accordance with applicable statutes. District officials … corrective action . Appendix B includes our comment on issues District officials raised in their response. … audit school brocton …
https://www.osc.ny.gov/local-government/audits/school-district/2023/08/04/brocton-central-school-district-financial-management-2023m-44