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Medicaid Program – Claims Processing Activity April 1, 2021 Through September 30, 2021
… computer system processes claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for their claims. During the 6-month period ended September … as follows: $28.5 million was paid for managed care premiums on behalf of enrollees who also had concurrent …
https://www.osc.ny.gov/state-agencies/audits/2022/08/19/medicaid-program-claims-processing-activity-april-1-2021-through-september-30-2021Medicaid Program – Medicaid Claims Processing Activity April 1, 2018 Through September 30, 2018
… system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for their claims. During the six-month period ended September … as follows: $123.9 million in Medicaid managed care premiums was paid on behalf of 86,475 Medicaid recipients who …
https://www.osc.ny.gov/state-agencies/audits/2019/07/10/medicaid-program-medicaid-claims-processing-activity-april-1-2018-through-september-30-2018State Agencies Bulletin No. 143
… Wages All wages subject to Medicare taxes. There is no salary cap on Medicare wages. Box 6 Medicare Tax Withheld The …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/143-1999-w-2-year-end-processingState Comptroller DiNapoli Releases Municipal Audits
… fiscal climate, budget transparency and accountability for our local communities is a top priority," said DiNapoli. … sales. Marina employees did not issue duplicate receipts for all money collected. Auditors also found that probation … acted outside its legal authority when it paid insurance premiums totaling $43,334 that included coverage for property …
https://www.osc.ny.gov/press/releases/2018/09/state-comptroller-dinapoli-releases-municipal-auditsState Comptroller DiNapoli Releases Audits
… controls to adequately monitor and enforce requirements for safety and quality of life on state waters in accordance … them. Department of Health (DOH): Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY …
https://www.osc.ny.gov/press/releases/2020/07/state-comptroller-dinapoli-releases-auditsUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services
… monitors out-of-network providers who routinely bill for higher-level Evaluation and Management services and to … levels of care that providers bill. The amount of United’s reimbursement depends on the level of care billed – the higher the level billed, the greater the reimbursement. Billing for a higher level of care, which is …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesIX.6.A Drawdown Overview – IX. Federal Grants
… made with most state agencies to have OSC act as agent for the agency to obtain reimbursement from the federal government of disbursements … agencies to have OSC act as agent for the agency to obtain reimbursement from the federal government of disbursements …
https://www.osc.ny.gov/state-agencies/gfo/chapter-ix/ix6a-drawdown-overviewMedicaid Overpayments for Certain Medicare Part C Claims (2013-S-35), 90-Day Response
We conducted an audit of the Department of Health (Department) to determine if Medicaid overpaid Medicare Part C claims on behalf of Medicaid recipients enrolle
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s35-response.pdfWestchester County Chapter NYSARC, Inc. – Compliance With the Reimbursable Cost Manual
… covered expenses reported on WARC’s 2015 and 2016 CFRs for the fiscal year ended June 30, 2016 and certain expenses … for these services through rates set by SED. The reimbursement rates are based on financial information, … WARC reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with RCM …
https://www.osc.ny.gov/state-agencies/audits/2021/09/29/westchester-county-chapter-nysarc-inc-compliance-reimbursable-cost-manualPinnacle Organization – Compliance With the Reimbursable Cost Manual
… The audit covered expenses reported on Pinnacle’s CFR for the fiscal year ended June 30, 2015 and certain expenses … special education services through rates set by SED. The reimbursement rates are based on financial information, … 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/2018/12/27/pinnacle-organization-compliance-reimbursable-cost-manualUnity House of Troy – Compliance With the Reimbursable Cost Manual
… 31, 2012. Background Unity is an SED-approved, not-for-profit special education provider located in Troy, New … special education services through rates set by SED. The reimbursement rates are based on financial information, … Unity reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with RCM …
https://www.osc.ny.gov/state-agencies/audits/2015/11/05/unity-house-troy-compliance-reimbursable-cost-manualLeake and Watts Services, Inc. – Compliance With the Reimbursable Cost Manual
… covered the expenses reported on Leake and Watts’ CFR for the fiscal year ended June 30, 2015. Background Leake and … special education services through rates set by SED. The reimbursement rates are based on financial information, … Watts reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with RCM …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/leake-and-watts-services-inc-compliance-reimbursable-cost-manualNew York Therapy Placement Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by New York Therapy Placement Services, Inc. (NYTPS) on its …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/new-york-therapy-placement-services-inc-compliance-reimbursable-cost-manualThe Arc of Orange County – Compliance With the Reimbursable Cost Manual
… reported on its CFR for the year ended December 31, 2013. In addition, we expanded our audit work to review certain … not-for-profit special education provider located in Orange County, New York. Arc Orange provides preschool … December 31, 2013, Arc Orange reported over $5.5 million in reimbursable costs on its CFR for four rate-based …
https://www.osc.ny.gov/state-agencies/audits/2016/03/17/arc-orange-county-compliance-reimbursable-cost-manualKids in Action of Long Island, Inc. – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Kids in Action of Long Island, Inc. (Kids in Action) on its Consolidated Fiscal Report (CFR) were …
https://www.osc.ny.gov/state-agencies/audits/2022/03/04/kids-action-long-island-inc-compliance-reimbursable-cost-manualParsons Child and Family Center – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Parsons Child and Family Center (Parsons) on its Consolidated Fiscal Report … (CFR) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the Reimbursable Cost Manual and the Consolidated Fiscal Reporting and Claiming Manual. …
https://www.osc.ny.gov/state-agencies/audits/2020/04/24/parsons-child-and-family-center-compliance-reimbursable-cost-manualThe New Interdisciplinary School – Compliance With the Reimbursable Cost Manual
… (RCM). The audit covered the expenses reported on NIS’ CFR for the fiscal year ended June 30, 2015, and certain expenses … special education services through rates set by SED. The reimbursement rates are based on financial information, … NIS 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/2017/12/08/new-interdisciplinary-school-compliance-reimbursable-cost-manualInspire (Orange County Cerebral Palsy Association) – Compliance With the Reimbursable Cost Manual
… array of outpatient, educational, and support services for individuals of all ages and abilities. Inspire is also an … for these services through rates set by SED. These reimbursement rates are based on financial information, … reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with RCM …
https://www.osc.ny.gov/state-agencies/audits/2015/12/29/inspire-orange-county-cerebral-palsy-association-compliance-reimbursable-cost-manualElmcrest Children’s Center, Inc. – Compliance With the Reimbursable Cost Manual
… The audit covered expenses reported on Elmcrest’s CFR for the fiscal year ended June 30, 2014. Background Elmcrest … for these services through rates set by SED. These reimbursement rates are based on financial information, … 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/2017/05/24/elmcrest-childrens-center-inc-compliance-reimbursable-cost-manualNorth Country Kids, Inc. – Compliance With the Reimbursable Cost Manual
… The audit covered expenses reported on North Country’s CFR for the fiscal year ended June 30, 2014, and certain expenses … special education services through rates set by SED. The reimbursement rates are based on financial information, … 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/2017/04/12/north-country-kids-inc-compliance-reimbursable-cost-manual