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Medicaid Program – Improper Fee-for-Service Payments for Services Covered by Long-Term Care Plans
… the Department of Health (Department) made improper fee-for-service (FFS) payments for certain services covered by managed long-term care (MLTC) … Medicaid FFS payments for MLTC services resulting from retroactive enrollments. … The objective of this audit was to …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/medicaid-program-improper-fee-service-payments-services-covered-long-term-care-plansCrossroads Center for Children – Compliance With the Reimbursable Cost Manual
… Cost Manual (2015-S-48) State Education Department: Story Place Preschool Inc. – Compliance With the …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/crossroads-center-children-compliance-reimbursable-cost-manualNew York State Health Insurance Program - Empire Plan Members With Dual Family Coverage
… organizations and members are paying excessively for dual Empire Plan Family coverage. The audit covered the … Article XI of the New York State Civil Service Law (Law) for the purpose of providing health insurance benefits to … employers and members pay their respective share of those premiums. However, while participating organizations are …
https://www.osc.ny.gov/state-agencies/audits/2021/01/07/new-york-state-health-insurance-program-empire-plan-members-dual-family-coverageAstor 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 … special education services through rates set by SED. These reimbursement rates are based on financial information, … Astor reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the guidelines …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-compliance-reimbursable-cost-manualChildren’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Children’s Unit for Treatment and Evaluation (CUTE) on its Consolidated … for these services through rates set by SED. The reimbursement rates are based on financial information, … CUTE reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …
https://www.osc.ny.gov/state-agencies/audits/2019/07/15/childrens-unit-treatment-and-evaluation-compliance-reimbursable-cost-manualUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… (United) paid claims using reasonable and customary (R&C) reimbursement rate schedules that did not correlate with the … The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Civil …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsRockland County – Budget Review (B6-13-22)
… expenditure projections in the County’s proposed budget for the 2014 fiscal year are reasonable. Background The … the cumulative deficit in the County’s general fund for the fiscal year ending December 31, 2012. Chapter 468 of … may be overestimating revenue from tax anticipation note premiums and could experience potential revenue shortfall if …
https://www.osc.ny.gov/local-government/audits/county/2013/11/25/rockland-county-budget-review-b6-13-22Association for the Advancement of the Blind and Retarded – Options for People Through Services Program
… Purpose To determine whether payments made by the Office for People With Developmental Disabilities (OPWDD) to the … than actual, expenses when developing its contractor reimbursement rates. OPWDD needs to enhance its monitoring of …
https://www.osc.ny.gov/state-agencies/audits/2013/07/26/association-advancement-blind-and-retarded-options-people-through-services-programIV.5.B Bond and Debt Proceeds – IV. Accounting Codes - Uses and Descriptions
… bonds and short-term notes issued in the form of commercial paper or Bond Anticipation Notes (BANs). Click … Proceeds from the sale of BANs by New York State. 36206 Commercial Paper Proceeds from the sale of Commercial Paper by New York State. 36301 Financing …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv5b-bond-and-debt-proceedsNew York’s Economy and Finances in the COVID-19 Era (June 24, 2021)
… a small share of overall utilization. The U.S. Centers for Medicare & Medicaid Services (CMS) defines telehealth … Department allows New York Medicaid providers the same reimbursement for delivering some services via telehealth …
https://www.osc.ny.gov/reports/new-yorks-economy-and-finances-covid-19-era-june-24-2021Medicaid Program – Claims Processing Activity April 1, 2023 Through September 30, 2023
… computer system processes claims submitted by providers for services rendered to Medicaid-eligible recipients and generates payments to reimburse the providers for their claims. During the 6-month period ending September … as follows: $9.3 million was paid for managed care premiums on behalf of Medicaid recipients who had other …
https://www.osc.ny.gov/state-agencies/audits/2024/04/24/medicaid-program-claims-processing-activity-april-1-2023-through-september-30-2023State Agencies Bulletin No. 1682
… To inform agency payroll officers of the new procedure for how OSC will handle current year Social Security and/or Medicare (FICA) tax deficiencies for inactive employees Affected Employees Employees who …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1682-current-year-social-security-andor-medicare-tax-deficiencies-and-impactAllocation, Billing, and Collection of Expenses of Administering the Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act
… on insurance carriers in proportion to their reported premiums. Certain fees paid by self-insurers and for bonded vehicles reduce the assessable expenses. Key … to administering the Acts. However, we identified areas for improvement. For example, the Department could better …
https://www.osc.ny.gov/state-agencies/audits/2019/12/13/allocation-billing-and-collection-expenses-administering-motor-vehicle-financial-securityDiNapoli: Former Non-Profit Executive Pleads Guilty to Falsifying Business Records
… increase her paid time off and lower her health insurance premiums, giving herself $5,518.77 in benefits that she was … to. "Today, Jennifer Thurber is being held accountable for her actions,” DiNapoli said. “She was entrusted with overseeing key business functions for an organization that does vital work with youth, but …
https://www.osc.ny.gov/press/releases/2021/08/dinapoli-former-non-profit-executive-pleads-guilty-falsifying-business-recordsDiNapoli Seeks Stronger Federal Safety Measures for Oil Trains to Protect New Yorkers
… Administration to strengthen safety measures to prevent oil spills and other hazardous accidents on New York’s … administrator of the New York Environmental Protection and Spill Compensation Fund ( Oil Spill Fund ), noted that accidents could easily …
https://www.osc.ny.gov/press/releases/2016/04/dinapoli-seeks-stronger-federal-safety-measures-oil-trains-protect-new-yorkersWest Seneca Fire District #2 – Purchasing and Capital Project Management (2018M-241)
… than $115,000. District officials did not obtain quotes for 16 of 21 purchases totaling approximately $56,000. The … may have improperly charged the District more than $14,000 for administrative fees and sales tax. Key Recommendations … invoices. Consult legal counsel and, if appropriate, seek reimbursement for the improper charges. District officials …
https://www.osc.ny.gov/local-government/audits/fire-district/2019/08/30/west-seneca-fire-district-2-purchasing-and-capital-project-management-2018mAllocation, Billing, and Collection of Expenses of Administering the Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act (Follow-Up)
… on insurance carriers in proportion to their reported premiums. The objective of our initial audit, issued December … to its practice of not adjusting its billing to account for amended premiums reported by insurance carriers. The Department also lacked a method for carrying prior period balances forward to subsequent …
https://www.osc.ny.gov/state-agencies/audits/2021/05/27/allocation-billing-and-collection-expenses-administering-motor-vehicle-financial-securityAudit of the Tuition Reimbursement Account for the Three Fiscal Years Ended March 31, 2013
… presentation of the Financial Statements of the Tuition Reimbursement Account for the three fiscal years ended March 31, 2013. Background … Chapter 887 of the Laws of 1990 created the Tuition Reimbursement Fund, now titled the Tuition Reimbursement …
https://www.osc.ny.gov/state-agencies/audits/2014/07/24/audit-tuition-reimbursement-account-three-fiscal-years-ended-march-31-2013Cantalician Center for Learning – Compliance With the Reimbursable Cost Manual
… reported by Cantalician Center for Learning (Cantalician) on its Consolidated Fiscal Reports (CFRs) were properly … calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the …
https://www.osc.ny.gov/state-agencies/audits/2023/01/26/cantalician-center-learning-compliance-reimbursable-cost-manualCenter for Disability Services – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by the Center for Disability Services (CFDS) on its Consolidated Fiscal … education program services through rates set by SED. These reimbursement rates are based on financial information, … CFDS reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with Manual …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/center-disability-services-compliance-reimbursable-cost-manual