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Medicaid Program – Improper Medicaid Payments for Misclassified Patient Discharges
… 31, 2019. About the Program The State’s Medicaid program is administered by the Department of Health (Department). The … of admission and when the services ended. This information is used to calculate the payment made to the hospital. … may vary significantly depending on whether a patient is transferred or discharged. For example, a claim where a …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesBenefits Advisement Services for Individuals With Disabilities Seeking Employment
… 75 percent for people without disabilities. Further, ACS data shows that New Yorkers with disabilities are more than … this be achieved was by improving benefits advisement services to assist all individuals with disabilities in … entities as necessary. Capture historical notification data for analysis and assessment of the effectiveness of WINR …
https://www.osc.ny.gov/state-agencies/audits/2021/07/20/benefits-advisement-services-individuals-disabilities-seeking-employmentUse of Federal Funding for Election Technology and Security
… Objective To determine whether the Board of Elections utilized … the 2018 Help America Vote Act Election Security Grant to enhance the security of the State’s election technology … To determine whether the Board of Elections BOE utilized …
https://www.osc.ny.gov/state-agencies/audits/2021/09/17/use-federal-funding-election-technology-and-securityUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… Objectives To determine whether UnitedHealthcare (United) paid claims … correlate with the date of the service on the claims, and to calculate the corresponding financial impact. The audit … (Civil Service), provides health insurance coverage to over 1.2 million active and retired State, local …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… Objective To determine the extent of implementation of the two recommendations made in our initial audit report, … Rebate Program, which allows states to recover a portion of their Medicaid prescription drug costs by requesting … To determine the extent of implementation of the two recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/maximizing-drug-rebates-health-and-recovery-plans-followEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates with … rate schedules for the payment of inpatient and outpatient hospital services. Hospitals may be entitled to additional …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… could achieve cost savings by implementation of a rental cap on oxygen equipment. The audit covered the period from … caps. For example, one MCO established a 10-month rental cap on apnea monitors, yet for one recipient the MCO paid … 64 extra rental payments for a monitor beyond the 10-month cap. Furthermore, we estimated potential cost avoidance for …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
… has the Department made enhancements to the Medicaid Data Warehouse to allow for a more thorough review of claims …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followAnnual Assessment of Market Orders for 2015 and 2016
… covered the period July 1, 2014 through June 30, 2016 for the Apple and Sour Cherry Market Orders and the period April 1, 2014 through March 31, 2016 for the Apple, Cabbage, and Onion Research and Development Programs. About the Program During the audit …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/annual-assessment-market-orders-2015-and-2016Medicaid Overpayments for Inpatient Care Involving Mechanical Ventilation Services
… Purpose To determine whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on … To determine whether Medicaid overpayments were made to hospitals for mechanical ventilation services reported on …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/medicaid-overpayments-inpatient-care-involving-mechanical-ventilation-servicesMedicaid Program – Medicaid Overpayments for Medicare Advantage Plan Services
… for services provided to enrollees. Generally, Medicaid is the secondary payer, and covers any financial balances … uses the CARCs to determine whether a billed service is eligible for payment as well as the correct payment … an incorrect CARC. Without the appropriate CARC, eMedNY is at risk of improperly adjudicating – and overpaying – …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-advantage-plan-servicesRestrictions on Consecutive Hours of Work for Nurses (Follow-Up)
… as health care disasters or a federal, State, or local declaration of an emergency. Our initial report, issued on …
https://www.osc.ny.gov/state-agencies/audits/2019/09/09/restrictions-consecutive-hours-work-nurses-followImplementation of the Dignity for All Students Act (Follow-Up)
… Objective To determine the extent of implementation of the three … New York State’s Dignity for All Students Act (DASA) seeks to provide students in New York with a safe and supportive … race, sexual orientation, weight) and required schools to designate a trained Dignity Act Coordinator (DAC). An …
https://www.osc.ny.gov/state-agencies/audits/2019/11/21/implementation-dignity-all-students-act-followBrighter Choice Charter School for Boys - Payroll (2018M-139)
… paid 15 employees who were paid $123,754 over four payroll periods during the audit period. 1 We reviewed the … Brighter Choice Charter School for Boys Payroll 2018M139 …
https://www.osc.ny.gov/local-government/audits/charter-school/2018/10/12/brighter-choice-charter-school-boys-payroll-2018m-139Medicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… Group codes include PR (patient responsibility) and CO (contractual obligation). CARC 45 occurs when the charge … configured to pay in eMedNY, while claims with a CARC CO 45 are not. All claims submitted for Medicaid members with …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsTown of Somerset – Budgeting for Sales Tax (2016M-419)
… Purpose of Audit The purpose of our audit was to review the Town's allocation of sales tax for the period January 1, 2015 through November … Town of Somerset Budgeting for Sales Tax 2016M419 …
https://www.osc.ny.gov/local-government/audits/town/2017/11/22/town-somerset-budgeting-sales-tax-2016m-419DiNapoli: State Needs to Improve Services for Vulnerable Adults
… The State Office of Children and Family Services is not adequately overseeing adult protective service providers responsible for protecting vulnerable adults to ensure they are handling … for protecting them must do a better job.” Elder abuse is a problem nationwide, with 1 in 10 older adults subject to …
https://www.osc.ny.gov/press/releases/2021/11/dinapoli-state-needs-improve-services-vulnerable-adultsDiNapoli Releases Fiscal Stress Scores for Villages and Cities
… from the COVID-19 pandemic. “The financial landscape for many local governments has improved with the infusion of … their financial outlook for years down the road.” The latest round of fiscal scores evaluated local governments … List Complete List of Fiscal Stress Scores Data Files FSMS Search Tool Tool Track state and local government spending at …
https://www.osc.ny.gov/press/releases/2022/04/dinapoli-releases-fiscal-stress-scores-villages-and-citiesDiNapoli: State Tax Collections Exceeded Estimates for SFY 2025-26
… of the Budget (DOB) in the 30-day amendments to the SFY 2026-27 Executive Budget financial plan, according to the March State Cash Report released today by New York State Comptroller Thomas P. … Benefit Trust for a total of $2.2 billion. March Cash Report …
https://www.osc.ny.gov/press/releases/2026/04/dinapoli-state-tax-collections-exceeded-estimates-sfy-2025-26Membership Milestones for Police & Fire Retirement System (PFRS) Members
… how your years of service affect your retirement benefits. For specific information about your retirement plan, go to … more years of service credit, you are: Eligible to apply for a non-job-related disability benefit. Eligible for an out-of-service death benefit, if you leave public …
https://www.osc.ny.gov/retirement/members/membership-milestones-police-fire-retirement-system-pfrs-members