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Medicaid Program – Improper Supplemental Maternity Capitation Payments to Managed Care Organizations
… 1, 2015 through July 31, 2020. About the Program The Department of Health (Department) administers New York’s … (SMCP) for the prenatal and postpartum physician care and hospital or birthing center delivery costs associated with … payments. The Department’s eMedNY claims processing system does not have access to maternity encounter data to verify …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-supplemental-maternity-capitation-payments-managed-careLong Island Association for AIDS Care, Inc.
… Inc. (LIAAC) charged and the Department of Health AIDS Institute (Institute) reimbursed for appropriate expenses under the … in common. Key Findings We found LIAAC charged and the Institute reimbursed LIAAC $178,466 for inappropriate or …
https://www.osc.ny.gov/state-agencies/audits/2014/09/30/long-island-association-aids-care-incTier 2, 3, 5 and 6 Death Benefits – Police and Fire Plan
… retirement(50 percent of ordinary death benefit): $84,600 2nd year of retirement(25 percent of ordinary death benefit): $42,300 After 2nd year of retirement(10 percent of benefit at age 60): …
https://www.osc.ny.gov/retirement/publications/1512/tier-2-3-5-and-6-death-benefitsMedicaid Program – Medicaid Claims Processing Activity April 1, 2018 Through September 30, 2018
… Objective To determine whether the Department of Health’s eMedNY system reasonably ensured that Medicaid … on behalf of 86,475 Medicaid recipients who had concurrent comprehensive third-party health insurance (TPHI); $6.1 … claims that were billed at a higher level of care than what was actually provided; $1 million was paid for claims …
https://www.osc.ny.gov/state-agencies/audits/2019/07/10/medicaid-program-medicaid-claims-processing-activity-april-1-2018-through-september-30-2018Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Report 2013-S-57). Background The … care. For example, MCOs receive a “Supplemental Low Birth Weight Newborn Capitation Payment” (low birth weight kick payment) for each enrolled newborn weighing …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followImproper Medicaid Payments to Hospitals for Outpatient Services Billed as Inpatient Services for Recipients Enrolled in Managed Care
… hospitals. The Centers for Medicare & Medicaid Services (CMS) defines outpatient care provided in a hospital as care … as an inpatient, even if the care takes place overnight. CMS guidance states inpatient admissions are generally …
https://www.osc.ny.gov/state-agencies/audits/2024/08/28/improper-medicaid-payments-hospitals-outpatient-services-billed-inpatient-servicesSecurity Self-Assessment: Questions – Information Technology Governance
… A fillable form is available for download and completion online at … approve, process and record transactions for each online bank account? 8c Are online bank accounts monitored? Yes No N/A Who monitors …
https://www.osc.ny.gov/local-government/publications/it-governance/security-self-assessment-questionsCity of Glen Cove – Budget Review (B7-15-17)
… of Budget Review The purpose of our budget review was to determine whether the significant revenue and expenditure … year are reasonable. Background The City of Glen Cove is located in Nassau County. Our Office completed a review of … fund. The City projects that, as of December 31, 2015, it will have unassigned fund balance deficits totaling …
https://www.osc.ny.gov/local-government/audits/city/2015/10/16/city-glen-cove-budget-review-b7-15-17Medicaid Program – Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns
… overpaid managed care organizations and hospitals for low birth weight newborn claims. The audit covered the period … effective April 1, 2012, MCOs receive a “Supplemental Low Birth Weight Newborn Capitation Payment” (low birth weight … birth weight kick payments are intended to cover the high cost of care these newborns require. Low birth weight kick …
https://www.osc.ny.gov/state-agencies/audits/2014/10/02/medicaid-program-overpayments-managed-care-organizations-and-hospitals-low-birth-weightOversight of Contract Expenditures of Palladia, Inc.
… year 2017-18, Palladia operated 31 distinct programs, 10 of which were contracted with OASAS. These 10 programs served 603 individuals in the fields of … in the Consolidated Fiscal Reporting and Claiming Manual (CFR Manual), OASAS’ Administrative and Fiscal Guidelines for …
https://www.osc.ny.gov/state-agencies/audits/2021/08/18/oversight-contract-expenditures-palladia-incMedicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… 14, 2015, the Department's new Encounter Intake System (EIS) began accepting encounter transactions from MCOs. (Prior to the EIS, MCOs submitted encounter transactions to the … system.) Encounter transactions must be submitted to the EIS in a format set by the Department. Specifically, the EIS …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemMaking Adjustments to Earnings and Days Worked – Enhanced Reporting
… If you need to correct a member’s earnings or days worked, … submit an adjustment using Retirement Online . Adjustments can be included in your regular report file. You can only … or faxed to 518-474-9898. For questions about adjustments, use our help desk form (select “Monthly Employer Reporting” …
https://www.osc.ny.gov/retirement/employers/enhanced-reporting/making-adjustments-earnings-and-days-workedMitchell-Lama Vacancies
… of vacant apartments, HPD’s Reporting and Compliance Directive (Directive), issued in June 2017, requires developments to … ensure their compliance with the requirements of its 2017 Directive. Despite the scarcity of affordable housing, vacant …
https://www.osc.ny.gov/state-agencies/audits/2021/07/13/mitchell-lama-vacanciesLinkNYC Program Revenues and Monitoring (Follow-Up)
… of implementation of the 18 recommendations included in our initial audit report, LinkNYC Program Revenues and … a first-of-its-kind communications network, LinkNYC, to bring municipal Wi-Fi to millions of New Yorkers, small … and visitors. The LinkNYC program was intended to replace an aging network of public pay telephones with …
https://www.osc.ny.gov/state-agencies/audits/2023/09/26/linknyc-program-revenues-and-monitoring-followNew York City Department of Homeless Services – Oversight of Contract Expenditures of Church Avenue Merchants Block Association, Inc.
… whether the New York City Department of Homeless Services (DHS) is effectively monitoring its contract with Church … (CAMBA) to ensure reported costs are allowable, supported, and program-related. The audit covered the period from July …
https://www.osc.ny.gov/state-agencies/audits/2025/07/14/new-york-city-department-homeless-services-oversight-contract-expenditures-church-avenueCUNY Bulletin No. CU-625
… Description IBEW Local 3 Dues 486 IBEW Local 3 Dues PSC 249 PSC DUES GRADS ASSISTANTS PSC 274 PSC DUES PSC 467 Adjunct Dues PSC OSC will NOT remove …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-625-updated-procedures-initiating-or-terminating-payrollUnified Court System Bulletin No. UCS-266
… Citywide Assoc Law Assts 228 Citywide Assoc Law Assts Court Attorney Assoc 237 Court Attorney Assoc Ct Off Ben … NYS Court Officers Assoc 243 NYS Court Officers Assoc Supreme Court Officer Assoc 240 Supreme Court Officer Assoc Sur/Sup Court Reporters 229 …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/unified-court-system/ucs-266-updated-procedures-initiating-or-terminating-payrollContract Advisory No. 4
… Subject: Corrective Action for Contract Transactions Created in the Statewide Financial … Subject to OSC Approval OSC will not approve any new contract where the SFS Audit ID includes a Business …
https://www.osc.ny.gov/state-agencies/advisories/contract-advisory/4-business-unit-and-department-id-combinations-used-create-contracts-statewidePhysical and Financial Conditions at Selected Mitchell-Lama Developments
… Housing Program (Program) was created in 1955 to provide affordable rental and cooperative (co-op) housing to … sampled developments failed to provide a safe and clean living environment for residents, and they misspent funds. … and gifts, including a $9,037 Rolex watch provided as a retirement gift for a building superintendent. We found …
https://www.osc.ny.gov/state-agencies/audits/2024/09/30/physical-and-financial-conditions-selected-mitchell-lama-developmentsReport File Transactions (File Upload) – Enhanced Reporting
… In the enhanced report file, you report employee information through transactions. … into NYSLRS membership whose membership is mandatory. You can also “ hire” an employee who is not joining NYSLRS (an …
https://www.osc.ny.gov/retirement/employers/enhanced-reporting/report-file-transactions-file-upload