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UnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… To determine whether UnitedHealthcare (United) paid claims using reasonable and customary (R&C) reimbursement … that did not correlate with the date of the service on the claims, and to calculate the corresponding financial impact. … United’s reimbursement for certain out-of-network claims is 80 percent of the R&C rate for the service. R&C …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsCVS Health – Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil Service
… Objective To determine if CVS Health appropriately invoiced drug … manufacturers and remitted corresponding rebate revenue to the Department of Civil Service for prescription drugs … To determine if CVS Health appropriately invoiced drug …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/cvs-health-accuracy-empire-plan-medicare-rx-drug-rebate-revenue-remitted-department-civilUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… drug is an outpatient drug (other than a vaccine) that is usually administered by a health care …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsEmpire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network
… Empire paid about $180.5 million for 158,305 special item claims during the audit period. Key Findings We found Empire did not pay for special item claims according to the terms of its contract with LIHN. … Empire overpaid LIHN hospitals $3,597,688 for 722 special item claims (83 percent of the claims sampled). As of July …
https://www.osc.ny.gov/state-agencies/audits/2019/11/29/empire-bluecross-improper-payments-special-items-billed-hospitals-within-long-island-healthAccounts Payable Advisory No. 20
… of record unless certified to dispose of the originals by the New York State Archives. Business Units must also …
https://www.osc.ny.gov/state-agencies/advisories/accounts-payable-advisory/20-document-attachments-sfsVillage of Addison – Former Clerk-Treasurer’s Misappropriation of Funds (2024M-19)
… former Clerk-Treasurer was required to forfeit her monthly public pension. This sentence represents the first time a public … official in New York State surrendered their pension as a penalty for corruption while in office. Key Recommendations …
https://www.osc.ny.gov/local-government/audits/village/2025/07/11/village-addison-former-clerk-treasurers-misappropriation-funds-2024m-19Unified Court System Bulletin No. UCS-268
… Purpose To inform agencies of the processing of the 2018 Prepaid … 10994 Note : The Zip code criteria is only applicable to members of District Council 37. Background Pursuant to Internal Revenue Code Section 61, certain fringe benefits … To inform agencies of the processing of the 2018 Prepaid …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-268-prepaid-legal-service-benefit-unified-court-system-ucsExamination of Pitts Management Associates, Inc. Travel Expenses
… Purpose The objective of our examination was to determine whether the travel … The initial contract, which was approved by the Office of the State Comptroller, required PMA to use reasonable … Instead, expenses were reimbursable on the basis of PMA’s actual cost. However, the contract extension, which …
https://www.osc.ny.gov/state-agencies/audits/2016/08/08/examination-pitts-management-associates-inc-travel-expensesOpinion 90-5
… or statutory amendments that bear on the issues discussed in the opinion. LIBRARIES -- Library Trustees (increase in their number) EDUCATION LAW, … (2): Although the town board appoints the trustees of a public library, the trustees are empowered to increase …
https://www.osc.ny.gov/legal-opinions/opinion-90-5Opinion 90-42
… FEES -- Exemption from (housing authority) -- Liability for (city tax districts) PUBLIC HOUSING AUTHORITY -- Fees … whether a city is liable for a fee for filing a list of properties affected by unpaid tax liens to be foreclosed by actions in rem, pursuant to title 3 of article …
https://www.osc.ny.gov/legal-opinions/opinion-90-42Opinion 97-14
… moneys may be expended by a volunteer fire department to pay the cost of constructing a trophy case in the department's meeting room, and to pay for furniture for the department's recreation room. … insurance tax moneys may be used by a vol fire dept to pay for constructing a trophy case and furniture for the …
https://www.osc.ny.gov/legal-opinions/opinion-97-14Opinion 93-11
… or statutory amendments that bear on the issues discussed in the opinion. BONDS AND NOTES -- Debt Limit (computation of … LAW, §104.00: The term "outstanding indebtedness" as used in General Municipal Law, §109-b(6)(c) includes only … which is not excludable pursuant to law. This is in reply to your inquiry asking whether the term "outstanding …
https://www.osc.ny.gov/legal-opinions/opinion-93-11XII.5.M Selecting the Appropriate Handling Code – XII. Expenditures
… can use them. Process and Document Preparation: HANDLING CODE DESCRIPTION A Handling code “A” allows a Business Unit’s courier to pick up a … Units processed that day, and Enter an “A” in the Handling Code box in the Payment Method section of the voucher to make …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii5m-selecting-appropriate-handling-codeUnified Court System Bulletin No. UCS-292
… unit SD will be affected. Employees represented by District Council 37 in bargaining unit SK who reside within … : The Zip code criteria is only applicable to members of District Council 37. Background Pursuant to Internal Revenue … listed below: Union Bargaining Units Value Earnings Code District Council 37 SK $107.00 PL3 CWA, Local 1180 SD $96.27 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-292-prepaid-legal-service-benefit-unified-court-system-ucsCUNY Bulletin No. CU-659
… not in bargaining unit AJ or GA and who cover a domestic partner for health insurance benefits will be affected. … employees pay for health insurance coverage for a domestic partner or other beneficiaries who are not legal spouses or … (Employer’s Tax Guide to Fringe Benefits), the estimated fair market value (FMV) of those benefits must be calculated …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-659-new-additional-pay-earn-codes-cuny-imputed-incomeUnified Court System Bulletin No. UCS-280
… Purpose The purpose of this bulletin is to inform agencies of the processing of the 2019 Prepaid … 10994 Note : The Zip code criteria is only applicable to members of District Council 37. Background Pursuant to Internal Revenue Code Section 61, certain fringe benefits …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-280-prepaid-legal-service-benefit-unified-court-system-ucsDiNapoli: Better Oversight Needed at Homeless Shelters
… State Comptroller Thomas P. DiNapoli found the Office of Temporary and Disability Assistance (OTDA) continues to … setting,” DiNapoli said. “In too many cases, the Office of Temporary and Disability Assistance is failing to ensure a … response is included in the audit. Full Report Office of Temporary and Disability Assistance: Oversight of Homeless …
https://www.osc.ny.gov/press/releases/2020/03/dinapoli-better-oversight-needed-homeless-sheltersAddiction Support Services During Emergencies (Follow-Up)
… included in our initial audit report, Addiction Support Services During Emergencies ( 2021-S-35 ). About the … providers to help ensure they’re able to deliver addiction support services during emergency situations. The audit found … service disruptions and continue to deliver addiction support services. Additionally, OASAS needs to improve its …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/addiction-support-services-during-emergencies-followKidz Therapy Services, PLLC – Compliance With the Reimbursable Cost Manual
… programs to disabled children between the ages of three and five years. During the 2013-14 school year, Kidz … payments to Kidz Therapy based on statutory rates. For the three fiscal years beginning July 1, 2011 and ended June 30, … 2014, Kidz Therapy reported approximately $4.77 million in reimbursable costs for its SEIT Program. In addition to …
https://www.osc.ny.gov/state-agencies/audits/2016/09/15/kidz-therapy-services-pllc-compliance-reimbursable-cost-manualTime and Attendance Practices of Selected Employees
… Each MTA agency requires its employees to document their hours worked. Work hours are supported by various documents … New York City income tax. In June 2010, LIRR paid 41 Car Repairmen for 7,558 hours worked, equating to $271,002. … not actually worked. Similarly, in July 2010, LIRR paid 40 Car Repairmen for 9,449 hours worked, equating to $356,588, …
https://www.osc.ny.gov/state-agencies/audits/2014/08/04/time-and-attendance-practices-selected-employees