Search
Medicaid Program – Medicaid Claims Processing Activity April 1, 2017 Through September 30, 2017
… eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were processed in accordance … eMedNY computer system processes Medicaid claims submitted by providers for services rendered to … eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers were processed …
https://www.osc.ny.gov/state-agencies/audits/2018/08/03/medicaid-program-medicaid-claims-processing-activity-april-1-2017-through-september-30-2017United HealthCare – Empire Plan Drug Rebate Revenue (Follow-Up)
… Purpose To determine the implementation status of the recommendation made in our audit report, United … To determine the implementation status of the recommendation made in our audit report United …
https://www.osc.ny.gov/state-agencies/audits/2017/05/15/united-healthcare-empire-plan-drug-rebate-revenue-followThe 80/20 Housing Program
… Program requirements regarding the number of designated affordable units and tenant eligibility; and to analyze the … HFA’s mission is to create and preserve high-quality, affordable, multifamily rental housing. Its 80/20 Program … these low-income units. Also, once tenants move into an affordable apartment, they may continue to reside in their …
https://www.osc.ny.gov/state-agencies/audits/2017/05/31/8020-housing-programWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported on the Consolidated Fiscal Reports (CFRs) of the Whitestone School … To determine whether the costs reported on the Consolidated Fiscal Reports of the Whitestone School for …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualNursing Home Surveillance
… Purpose To determine whether the Department of Health (Department) consistently follows federal and State … facility inspections, referred to as surveys. Standard Health and Life Safety Code surveys are unannounced and must … is generally meeting its obligations to conduct Standard Health and Complaint surveys in accordance with federal and …
https://www.osc.ny.gov/state-agencies/audits/2016/02/19/nursing-home-surveillancePractices Used by the Transit Adjudication Bureau to Collect and Account for Fines and Fees
… processing and adjudicating summonses for violations of NYC Transit (Transit) rules governing public use of the … decreased materially over the past few years. During the week of June 14, 2013, 50.45 percent of possible calls were made, while about two years later, during the week of February 13, 2015, only 25.18 percent of possible …
https://www.osc.ny.gov/state-agencies/audits/2016/08/11/practices-used-transit-adjudication-bureau-collect-and-account-fines-and-feesMedicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… Purpose To determine the readiness of all Medicaid managed care organizations … (MCOs) to submit Medicaid encounter transactions to the new Encounter Intake System. We conducted an early assessment of the readiness of Medicaid MCOs as of September 30, 2015. We …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemDriver Responsibility Assessment Program
… Program fees due from violators and that it suspended the licenses, or the privilege to obtain a license, of drivers … fees and either collected these fees or suspended the licenses or the privilege to obtain a license of drivers who …
https://www.osc.ny.gov/state-agencies/audits/2014/10/09/driver-responsibility-assessment-programFinancial Management Practices
… necessary steps to promptly meet applicable Federal and State dam safety requirements. Other Related Audits/Reports …
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
… The Department of Health (Department) administers the State’s Medicaid program. The Department’s eMedNY computer … for pharmacy claims that were not in compliance with State Medicaid policies; and $167,101 for claims with …
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
… of Interest Tuition Assistance Program: Stony Brook University (2015-T-2) Tuition Assistance Program: …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/tuition-assistance-program-metropolitan-learning-instituteFuel Purchases
… Authority (Authority) is purchasing the correct type of fuel, paying the proper amount for the fuel purchased, receiving the correct amount of fuel, and keeping accurate records of the supply and … Authority Authority is purchasing the correct type of fuel paying the proper a …
https://www.osc.ny.gov/state-agencies/audits/2015/02/27/fuel-purchasesAccountability for Traffic Ticket Surcharges
… 1, 2012 through July 31, 2014. Background New York State Vehicle and Traffic Law authorizes cities with a population … date of violation – that cannot be waived. However, the Vehicle and Traffic Law does impose a cap on the total amount …
https://www.osc.ny.gov/state-agencies/audits/2015/08/10/accountability-traffic-ticket-surchargesMedicaid Program – Payments for Death-Related One-Day Inpatient Admissions
… with hospital charges totaling $9,685 for a patient who died within the first day of admission. The APR DRG-based …
https://www.osc.ny.gov/state-agencies/audits/2013/08/15/medicaid-program-payments-death-related-one-day-inpatient-admissionsDual Employment
… in any further investigation. Establish communication channels between facilities that utilize dually employed or …
https://www.osc.ny.gov/state-agencies/audits/2013/12/19/dual-employment-2Medicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… Purpose To determine whether the Department of Health's eMedNY system processes Medicaid claims for … rates for inpatient hospital claims include the costs of most medical care provided during a hospital admission. As … and reported to Department officials. However, at the time of our audit fieldwork, Department officials had not taken …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientMedicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… Purpose To determine whether mainstream managed care organizations (MCOs) are submitting accurate … the administrative costs in determining mainstream managed care premium rates. Our audit covered the period January 1, … are economically disadvantaged and/or have special health care needs. For the State fiscal year ended March 31, 2015, …
https://www.osc.ny.gov/state-agencies/audits/2016/10/13/medicaid-program-mainstream-managed-care-organizations-administrative-costs-used-premiumInmate Sentence Calculation and Release Practices
… of Corrections and Community Supervision: Oversight of Sex Offenders Subject to Strict and Intensive Supervision and …
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
… range of services including, but not limited to, hospital services, office visits, home care, medical … rate schedules for the payment of inpatient and outpatient hospital services. Empire’s hospital contracts also allow certain special items, such as …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsSelected Wage Investigation Procedures (Follow-Up)
… require employers found to be in violation of the Laws to pay restitution of wages and can also assess penalties (which … amounts for aggrieved workers. DOL reported collecting $21 million, $18 million, and $21 million in penalties, wages, … of its wage investigations during calendar years 2022, 2021, and 2020, respectively. The objective of our initial …
https://www.osc.ny.gov/state-agencies/audits/2024/02/16/selected-wage-investigation-procedures-follow