On October 4,
2023, State Comptroller Thomas P. DiNapoli announced the audits of State Departments, Agencies, Public Authorities and other entities listed below were issued.
Click on the text highlighted in color to access both the summary and the complete
audit report
Metropolitan Transportation Authority – New York City
Transit: Risk Assessment and Implementation of Measures to Address Extreme
Weather Conditions (2021-S-27)
Flooding remains
a serious issue for the City and the Metropolitan Transportation Agency’s (MTA)
transportation system, including New York City Transit (Transit). In September
2007, the Chair of the MTA appointed a commission to make sustainability-related
recommendations to the MTA and its agencies. The audit found that, to date, the
MTA has not implemented one of the most important recommendations – the
development of the climate change adaptation master plan. Further, review of a sample
of capital projects intended to correct or prevent damage found that projects
were often incomplete in scope of work, not finished on time or within budget,
or insufficiently documented.
Department of State – Implementation of the Security
Guard Act (Follow-Up) (2023-F-20)
Article 7-A of
the General Business Law, also known as the Security Guard Act (Act), requires
that individuals working as security guards have a valid registration card and
entrusts the Department of State (DOS) with issuing registration cards. The Act
also requires guards to complete training and renew their registration every 2
years. A prior audit, issued in July 2021, found security guards classified as
police/peace officers did not fulfill their training requirements, including
armed guards who did not complete the required firearms training. The follow-up
found DOS made significant progress in addressing the problems identified in
the initial audit report, implementing a new procedure for monitoring and
reviewing training records. Of the initial report’s four audit recommendations,
three were fully implemented and one was partially implemented.
Department of Transportation – Compliance With Freedom of
Information Law Requirements (2020-S-12)
The New York
Freedom of Information Law (FOIL) provides for public access to government
records. Under FOIL, agencies, including the Department of Transportation (DOT),
must make all eligible records available for public inspection or copying upon
request. The audit found DOT did not always comply with the FOIL requirements,
identifying instances of non-compliance, including cases of DOT not providing
the requested records available, denying the request, or failing to acknowledge
the request within the statutory time frame. Furthermore, DOT obstructed the
audit by, among other actions, requiring that all meetings be attended by
supervisory staff from DOT’s main office and not providing all requested
information.
New York Power Authority – Selected Management and
Operations Practices: BuildSmart NY/Executive Order 88 (2023-S-27)
BuildSmart NY is a program created to
carry out Executive Order 88 (EO 88), which mandated a 20% improvement in the
energy efficiency performance of State government buildings by April
2020 and the BuildSmart 2025 program expands upon the original program and
sets new objectives equivalent to a 34% reduction in energy usage. The New York
Power Authority (NYPA) administers EO 88 and organizations subject to EO 88
(Affected State Entities [ASEs]) work with NYPA to achieve their allotted
portion of the overall savings targeted by 2025. NYPA’s Final Report shows the
actual reduction reported was 14.4% by April 2020, and when committed projects
(incomplete) are added, the reduction is 22.6%. However, the report includes
123 projects of 158 that are not scheduled to be completed until as late as
2024. Additionally, when NYPA annually reported the status of the BuildSmart NY
program, officials shied away from identifying the deficiencies in ASE
non-compliance and instead asserted that they had no ability to enforce EO 88.
State Education Department – Adult Career and Continuing
Education Services: Vocational Rehabilitation Supported Employment Program
(Follow-Up) (2023-F-15)
The State
Education Department’s (SED) Adult Career and Continuing Education Services –
Vocational Rehabilitation (ACCES-VR) program provides vocational rehabilitation
services for and supports the employment goals of people with a disability. To
help program participants achieve and maintain employment, counselors develop
an Individualized Plan for Employment (IPE) with each participant, which
identifies the employment goal, services that will be provided to help achieve
that goal, and how progress will be measured. A prior audit, issued in March
2022, found that SED did not always meet the time frames for eligibility
determinations or finalization and annual reviews of IPEs and SED did not
provide any documented evaluations to show the ACCES-VR program was being
adequately monitored. The follow-up found SED made progress addressing the
issues identified in the initial audit report, replacing its case management
system to allow for improved oversight and developing step-by-step guidance for
counselors completing IPEs. Of the initial report’s three recommendations, two
were implemented and one was partially implemented.
State Education Department – Oversight of Mental Health
Education in Schools (Follow-Up) (2023-F-21)
Under Section
804 of the Education Law (Law), the State Education Department (SED) is
responsible for enforcing a requirement for mental health education in schools.
An initial audit, issued in April 2022, found that mental health teams at many
school districts were understaffed and that SED did not require school districts
to submit any documentation indicating compliance with the Law. SED made
progress in addressing the problems identified in the initial audit report,
developing a mechanism to determine if schools are providing mental health
education and taking steps to secure more mental health staffing. Both
recommendations from the initial report were implemented.
New York City Office of Technology and Innovation –
LinkNYC Program Revenues and Monitoring (Follow-Up) (2022-F-25)
New York City’s Office of Technology
and Innovation (OTI) procures citywide IT services. In December 2014, NYC
entered into a Franchise Agreement (Agreement) with a consortium of technology,
media, and connectivity providers (Consortium) to replace aging public pay
telephones with state-of-the-art connection points called Links that would
offer free Internet access and phone service. A prior audit issued in July 2021
found that OTI did not sufficiently monitor and enforce the Consortium’s
compliance with the Agreement terms, including the collection of almost $70
million due to NYC. The follow-up found that OTI made progress in addressing
these issues, but it could do more to ensure revenues owed are assessed and
collected correctly and Links are properly installed and maintained. Of the
initial report’s 18 recommendations, seven were implemented, six were partially
implemented, and five were not implemented.
Medicaid Program – Recovering Managed Care Payments for
Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
(2021-S-24)
For Medicaid
recipients enrolled in managed care, the Department of Health (DOH) pays
managed care organizations (MCOs) a monthly premium for each enrolled
recipient, and, in turn, the MCOs arrange for their health care services,
including inpatient services. Many recipients have other third-party health
insurance (TPHI) in addition to Medicaid. Medicaid is considered the payer of
last resort, and, as such, MCOs are required to coordinate benefits with the
recipient’s TPHI prior to paying for Medicaid services. The Office of the
Medicaid Inspector General uses a contractor to identify and recover payments
made for services that should have been paid for by a recipient’s TPHI. During
the audit period, the contractor did not bill TPHI carriers or initiate
provider reviews for the recovery of $52.2 million in inpatient claims where
MCOs paid as the primary insurance despite recipients having TPHI inpatient
coverage.
Department of Health: Medicaid Program – Improper
Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing,
Referring, and Attending Requirements (Follow-Up) (2023-F-4)
As of January 1,
2014, New York’s Medicaid program required health care professionals who order,
prescribe, refer, or attend (OPRA) Medicaid services be appropriately screened
and enrolled in Medicaid and their National Provider Identifier (NPI) – a
unique identification number – to be included on Medicaid claims. A prior audit
issued in August 2021 found Medicaid made over $1.5 billion in improper and
questionable payments for claims that did not contain an enrolled or affiliated
OPRA NPI as required or where the NPI was not properly validated by the
Department of Health (DOH) at the time of payment, and $19.4 million in
payments for claims that contained an OPRA NPI that should not be included on
Medicaid claims or that should be further reviewed by DOH due to past
misconduct. The follow-up found that none of the improper and questionable
payments have been reviewed. Furthermore, DOH has not improved system controls
to prevent improper use of an override option for pharmacy claims that were
denied because they did not contain the NPI of an enrolled provider in the
prescribing field, and, as a result, auditors identified another $11.3 million
in improper pharmacy payments since the initial audit. Of the initial report’s
12 audit recommendations, one was implemented, three were partially
implemented, and eight were not implemented.
New York State Health Insurance Program –
UnitedHealthcare Insurance Company of New York: Overpayments for
Physician-Administered Drugs (2021-S-32)
The Department
of Civil Service contracts with UnitedHealthcare Insurance Company of New York (United) to administer
the Medical/Surgical Program of the Empire Plan, which covers a range of
services, including physician-administered drugs, which are also covered under
the Empire Plan’s separate Prescription Drug Program. A physician-administered
drug is an outpatient drug (other than a vaccine) that is usually administered
by a health care provider in a physician’s office or other outpatient clinical
setting. The audit identified $5,536,537 in actual and potential overpayments
for the cost of physician-administered drugs during the audit period. As of March 29, 2023, United recovered $254,188 of the improper
payments.
New York State Health Insurance Program – Empire
BlueCross: Overpayments for Physician- Administered Drugs (2021-S-33)
The Department
of Civil Service contracts with Empire BlueCross (Empire) to administer the
Hospital Program of the Empire Plan, which covers services including
physician-administered drugs. A physician-administered drug is a drug, other
than a vaccine, that is typically administered by a health care professional in
a hospital or facility setting. In certain circumstances,
physician-administered drugs are paid under the Empire Plan’s separate
Prescription Drug Program, but both programs should not pay for the same
physician-administered drug for the same patient on the same date of service.
The audit identified $2,776,510 in actual and potential overpayments for the
cost of physician-administered drugs during the audit period. As of June 21, 2023, Empire had started recoveries for $116,287 of
the improper payments.
Department of Civil Service – New York State Health
Insurance Program: Incorrect Payments by CVS Caremark for Medicare Rx Drug
Claims That Were Improperly Paid Under the Commercial Plan (2022-S-24)
The Department
of Civil Service (Civil Service) contracts with CaremarkPCS Health, L.L.C. (CVS
Caremark) to administer the prescription drug program for the Empire Plan,
which includes the Empire Plan Medicare Rx drug plan (Medicare Rx Plan) for
retired members and their dependents who have Medicare, and a Commercial Plan
for members and their dependents who do not have Medicare. Claims paid under
the Medicare Rx Plan are eligible for enhanced drug manufacturer discounts and
federal subsidies that are not available for claims paid under the Commercial.
For the audit period, auditors identified claims totaling $12,358,531 that were
incorrectly paid under the Commercial Plan instead of the Medicare Rx Plan.
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