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Interdisciplinary Center for Child Development – Compliance With the Reimbursable Cost Manual
… for-profit organization authorized by SED to provide preschool special education services to children with … $30.2 million in reimbursable costs for the SED preschool special education cost-based programs. In addition, … $176,793 in compensation related to excess staffing of teacher aides/assistants; $1,765 in over-allocated and/or …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/interdisciplinary-center-child-development-compliance-reimbursable-cost-manualReducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up)
… Purpose To determine the implementation status of the five … audit report on March 1, 2017. The audit objective was to determine whether the Department of Health (Department) took sufficient steps to control the Medicaid costs of recipients diagnosed with … To determine the implementation status of the five …
https://www.osc.ny.gov/state-agencies/audits/2018/09/05/reducing-medicaid-costs-recipients-end-stage-renal-disease-followAdministration of Contract C007373 With the Institute for Community Living
… Purpose To determine whether the Office of Mental Health (OMH) is effectively administering its contract with the Institute for Community Living (ICL) by ensuring that contracted services were actually provided, … To determine whether the Office of Mental Health OMH is effectively administering …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-c007373-institute-community-livingAdministration of the Contract With the Postgraduate Center for Mental Health
… Housing Contract C007374 with the Postgraduate Center for Mental Health (PCMH) by ensuring that contracted services … contractors to operate many of these programs. PCMH, a not-for-profit entity, is one of New York’s largest providers of … all contract costs and serves as a cost claiming document for program reimbursement. At the end of each contract year, …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-postgraduate-center-mental-healthWestchester School for Special Children – Compliance With the Reimbursable Cost Manual
… $802,912 in claimed costs (including $610,507 in personal service costs and $192,405 in other-than-personal-service costs) because they were ineligible per the Manual. … Park; $1,620 at a cigar store; and $369 at Victoria's Secret. Although the former Executive Director eventually …
https://www.osc.ny.gov/state-agencies/audits/2013/07/02/westchester-school-special-children-compliance-reimbursable-cost-manualChildren’s Center for Early Learning – Compliance With the Reimbursable Cost Manual
To determine whether the expenses reported on the Consolidated Fiscal Reports CFRs of the Childrens Center for Early Learning Center were calculated proper
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/childrens-center-early-learning-compliance-reimbursable-cost-manualWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported on the Consolidated … properly, documented adequately, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost … provides a full-day preschool special education program to disabled children between the ages of three and five …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualUnited HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
… Members pay a nominal co-payment to the participating provider for the services rendered. Members may also choose … requirements, when United processes a non-participating provider’s claims, it is with the understanding that Empire … cost-sharing obligations. However, if a non-participating provider does not collect (i.e., waives) the member’s …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-spine-specialistsMedicaid 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 … To determine the readiness of all Medicaid managed care organizations to submit Medicaid encounter transactions to the new …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background Our … was issued on December 9, 2010, examined whether nursing home claims submitted to Medicaid for hospital bed reserve … days were appropriate, and if not, to what extent nursing home claims exceeded the bed reserve day limits. During the …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… in our initial audit report, Excessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits … whether the Department was correctly paying claims for services to Medicaid recipients who also have health … and proactive steps to administer Medicaid reimbursements for services provided to dual eligible individuals. About …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followUnited HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… Members pay a nominal co-payment to the participating provider for the services rendered. Members may also choose … requirements, when United processes a non-participating provider’s claims, it is with the understanding that Empire … cost-sharing obligations. However, if a non-participating provider does not collect (i.e., waives) the member’s …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-laparoscopic-surgeryAstor Services for Children & Families – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Astor Services for Children & Families (Astor) on its Consolidated Fiscal … fiscal year ended June 30, 2013. Background Astor, a not-for-profit organization located in Rhinebeck, New York, … the ages of three and five years. Astor is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-compliance-reimbursable-cost-manualImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… State’s Medicaid program provides a wide range of health care services, including prescription drugs, to individuals … are economically disadvantaged and/or have special health care needs. The New York State Controlled Substances Act … allowed by the Act. We further identified 3,323 managed care claims for controlled substances in which the quantities …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followImproper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… Purpose To determine the extent of implementation of the three … We also recommended the Department take corrective action to help ensure managed care enrollment information is entered and update timely and to determine why certain fee-for-service claims were …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followStarting Point Services for Children – Compliance With the Reimbursable Cost Manual
… Education Itinerant Teacher (SEIT) and Special Class Integrated Setting (SCIS) programs to disabled children … These ineligible costs included $2,228,711 in personal service costs and $356,743 in other than personal service costs. Among the disallowances we identified were: …
https://www.osc.ny.gov/state-agencies/audits/2015/12/11/starting-point-services-children-compliance-reimbursable-cost-manualUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… Interest New York State Health Insurance Program: United HealthCare - Certain Claim Payments for Evaluation and …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59Milestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the Milestone School for Child Development (Milestone) on its … documented, program related, and allowable pursuant to the State Education Department’s (SED) Reimbursable Cost … Determine whether the costs reported by Milestone School for Child Development …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualAdministration of the Contract With the Center for Urban Community Services
… Purpose We audited the New York City Department of Health and Mental Hygiene’s … increased to $28.7 million for expanded program services. The New York State Office of Mental Health funds about 75 … We audited the New York City Department of Health and Mental Hygienes …
https://www.osc.ny.gov/state-agencies/audits/2016/02/16/administration-contract-center-urban-community-servicesMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… two separate payments are made: a payment for the first hospital’s claim and a payment for the second hospital’s claim. However, according to the Department’s … when a recipient is transferred from the first hospital to a merged or consolidated division or hospital, …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilities