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Anthem Blue Cross – Coordination of Benefits with Medicare (2023-S-30)
To determine whether Anthem Blue Cross coordinated benefits to properly pay claims for NYSHIP Empire Plan members with Medicare coverage.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2024-23s30.pdfChildren’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual
… covered expenses reported on CUTE’s CFR for the fiscal year ended June 30, 2016 and certain costs reported on its …
https://www.osc.ny.gov/state-agencies/audits/2019/07/15/childrens-unit-treatment-and-evaluation-compliance-reimbursable-cost-manualNYSARC, Inc. – NYC Chapter (School-Age Program): Compliance With the Reimbursable Cost Manual
… on expenses claimed on NYSARC’s CFR for the fiscal year ended June 30, 2015, and included certain expenses … were enrolled in this program during the 2014-15 school year. The New York City Department of Education (DoE) refers …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/nysarc-inc-nyc-chapter-school-age-program-compliance-reimbursable-cost-manualNew York Therapy Placement Services, Inc. – Compliance With the Reimbursable Cost Manual
… (CFRs) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) … on NYTPS’ CFR for the fiscal year ended June 30, 2014 and certain expenses reported on NYTPS’ CFRs for the two … to children with disabilities who are between three and five years of age. NYTPS is reimbursed for these services …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/new-york-therapy-placement-services-inc-compliance-reimbursable-cost-manualSchool for Language and Communication Development – Compliance With the Reimbursable Cost Manual
… covered the expenses reported on SLCD’s CFR for the fiscal year ended June 30, 2015, and certain expenses reported on …
https://www.osc.ny.gov/state-agencies/audits/2018/04/16/school-language-and-communication-development-compliance-reimbursable-cost-manualMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… Department. To prevent such premium payments – and, in the case of unrelated-provider coverages, unrecoverable premium …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyJust Kids Early Childhood Learning Center – Compliance With the Reimbursable Cost Manual
… directly related to the special education program, and sufficiently documented pursuant to the State Education … on Just Kids’ CFRs for the fiscal years 2011-12, 2012-13, and 2013-14. Background Just Kids Early Childhood Learning … Education Itinerant Teacher (SEIT), Special Class (SC), and Special Class in an Integrated Setting (SCIS) programs to …
https://www.osc.ny.gov/state-agencies/audits/2015/12/31/just-kids-early-childhood-learning-center-compliance-reimbursable-cost-manualMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… included 4,240 adults and 141 children whose Medicaid case information did not note a spouse or parent. Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-diseaseLifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… on expenses claimed on Lifeline’s CFR for the fiscal year ended June 30, 2015, and included certain expenses … that exceeded the 3.5 percent limit set by SED, and $6,444 that was not supported by performance evaluations; … to four employees, $7,015 for repairs and maintenance, $6,513 for staff travel and development, $5,175 for tuition …
https://www.osc.ny.gov/state-agencies/audits/2017/10/12/lifeline-center-child-development-inc-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… With the Reimbursable Cost Manual ( 2015-S-19 ) New York League for Early Learning, Inc.: Compliance With the …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualClinical Associates of the Finger Lakes – Compliance With the Reimbursable Cost Manual
… Cost Manual (RCM). The audit covered the fiscal year ended June 30, 2012. Background CAFL is a privately … with the guidelines specified in the RCM. For the fiscal year ended June 30, 2012, CAFL reported $1.2 million in …
https://www.osc.ny.gov/state-agencies/audits/2015/07/22/clinical-associates-finger-lakes-compliance-reimbursable-cost-manualRiverbank State Park – Administration of the Concession Contract With Riverbank Restaurant Group
… of indoor and outdoor athletic and cultural facilities. In March 2004, Parks entered into a 10-year contract with RRG … from this contract were estimated at $160,000 annually. In addition to paying the monthly licensing fees, RRG was contractually required to invest a minimum of $622,000 in capital improvements and concession-related upgrades. Key …
https://www.osc.ny.gov/state-agencies/audits/2014/11/24/riverbank-state-park-administration-concession-contract-riverbank-restaurant-groupThe Arc Erie County New York – Compliance With the Reimbursable Cost Manual
To determine whether the costs reported by The Arc Erie County New York on its Consolidated Fiscal Reports were properly calculated adequately documented and allowable under the State Education Departments guidelines including the Reimbursable Cost Manual and the
https://www.osc.ny.gov/state-agencies/audits/2022/12/06/arc-erie-county-new-york-compliance-reimbursable-cost-manualDiNapoli: Thousands of Young Children With Disabilities Not Receiving Early Intervention Services
… delayed services. Since DOH does not require explanations, case files rarely identified why consent was not given, why a …
https://www.osc.ny.gov/press/releases/2023/02/dinapoli-thousands-young-children-disabilities-not-receiving-early-intervention-servicesDiNapoli: Huntington Man Charged With Stealing Over $56,000 in State Pension Payments
… of Huntington, for allegedly stealing his mother’s public pension payments following her death in April of 2021. “Mr. … dollars he was not entitled to,” DiNapoli said. “Thanks to my investigators and Suffolk County District Attorney … Tierney, he is being held accountable for his crime. My office will continue to work with law enforcement agencies …
https://www.osc.ny.gov/press/releases/2023/10/dinapoli-huntington-man-charged-stealing-over-56000-state-pension-paymentsDiNapoli: Texas Woman Charged with Stealing Over $65,000 in NYS Pension Payments
… Texas woman for allegedly stealing more than $65,000 in New York state pension payments meant for a deceased acquaintance. Christy … determined that Gibson used the joint account to pay for entertainment and food. Gibson also made electronic …
https://www.osc.ny.gov/press/releases/2023/07/dinapoli-texas-woman-charged-stealing-over-65000-nys-pension-paymentsMedicaid Program – Improper Fee-for-Service Pharmacy Payments for Recipients With Third-Party Health Insurance
… third-party health insurance (TPHI) for pharmacy services in addition to Medicaid (e.g., employer-based coverage, … to prevent TPHI overpayments from occurring. Beginning in 2023, pharmacy services for recipients enrolled in some managed care plans will be covered by FFS; therefore, …
https://www.osc.ny.gov/state-agencies/audits/2023/05/11/medicaid-program-improper-fee-service-pharmacy-payments-recipients-third-party-healthLittle Meadows Early Childhood Center, Inc. – Compliance With the Reimbursable Cost Manual
… 2018, Little Meadows reported approximately $10.2 million in reimbursable costs for the SED preschool cost-based … 3 fiscal years ended June 30, 2018, we identified $395,644 in reported costs that did not comply with the requirements in the RCM and the CFR Manual, as follows: $192,089 in …
https://www.osc.ny.gov/state-agencies/audits/2022/07/07/little-meadows-early-childhood-center-inc-compliance-reimbursable-cost-manualKids Unlimited, PT, OT & SLP, PLLC – Compliance With the Reimbursable Cost Manual
… on expenses claimed on Kids Unlimited’s CFR for the fiscal year ended June 30, 2015 and certain expenses claimed on its … children in New York City’s five boroughs. For the fiscal year ended June 30, 2015, Kids Unlimited served 143 children. … $173,650 in over-reported health insurance benefits; $6,281 in unsupported depreciation expenses; and $2,715 in …
https://www.osc.ny.gov/state-agencies/audits/2020/12/31/kids-unlimited-pt-ot-slp-pllc-compliance-reimbursable-cost-manualQuality Services for the Autism Community – Compliance With the Reimbursable Cost Manual
… to the State Education Department’s (SED) Reimbursable Cost Manual (RCM). The audit included expenses claimed on … 2015, QSAC received $3.7 million in State funding for the cost-based SC and SEIT programs. The cost for the Office for People With Developmental …
https://www.osc.ny.gov/state-agencies/audits/2019/12/31/quality-services-autism-community-compliance-reimbursable-cost-manual