ulster county ucp audit 1

7/29/2019 Ulster County UCP Audit 1

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NEW YORK STATEDEPARTMENT OF HEALTH

OFFICE OF THE MEDICAID INSPECTOR GENERAL

REVIEW OF UCP OF ULSTER COUNTYCLAIMS FOR DAY TREATMENT SERVICES

PAID FROMJANUARY 1, 2005 - DECEMBER 31, 2008

FINAL AUDIT REPORTAUDIT #10-5762

James C. CoxMedicaid Inspector General

July 11,2013


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ANDREW M. CUOMO

GOVERNOR

STATE OF NEW YORK


800 North Pearl Street

Albany, NY 12204

JAMESC. COX

MEDICAID INSPECTOR GENERAL

July 11, 2013

Ms. Pam CarroadExecutive DirectorUCP of Ulster County Day TreatmentP.O. Box 1488Kingston, New York 12402

Re: Final Audit ReportAudit #: 10-5762

Dear Ms. Carroad:

Enclosed is the Office of the Medicaid Inspector General (OMIG) final audit report entitled"Review of UCP of Ulster Day Treatment" (the Provider) paid claims for day treatment servicescovering the period January 1, 2005, through December 31, 2008.

In the attached final audit report, the OMIG has detailed our scope, procedures, laws,regulations, rules and policies, sampling t~chnique, findings, provider rights, and statisticalanalysis.

The OMIG has attached the sample detail for the paid claims determined to be in error. Thisfinal audit report incorporates consideration of any additional documentation and informationpresented in response to the draft audit report dated October 17, 2011. The mean pointestimate overpaid is $1,737,482. The lower confidence limit of the amount overpaid is

$1,277,133. We are 95% certain that the actual amount of the overpayment is greater than thelower confidence limit. This audit may be settled through repayment of the lower confidencelimit of $1,277,133.


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Ms. Pam CarroadPage 2

July 11,2013

If the Provider has any questions or comments concerning this final audit report, please contact

Thomas A. Barone at (518) 486-7200 or through email at [email protected] refer to report number 10-5762 in all correspondence.

Sincerely,

Paul E. Barry

Coordinator, Medical Facilities Audit

Division of Medicaid Audit, Albany Office

Office of the Medicaid Inspector General

PEB/slmEnclosure

CERTIFIED MAIL #7010-1870-0000-4853-1034RETURN RECEIPT REQUESTED

Ver-3.0
mailto:[email protected]:[email protected].


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www.omig.ny.gov

The mission of the Office of the Medicaid Inspector General (OMIG), as mandated by New York

Public Health Law 31 is to preserve the integrity of the New York State Medicaid program by

preventing and detecting fraudulent, abusive and wasteful practices within the Medicaidprogram and recovering improperly expended Medicaid funds.

DIVISION OF MEDICAID AUDIT

,

The Division of Medicaid Audit professional staff conducts audits and reviews of Medicaid

providers to assess compliance and program requirements and, where necessary, to recover

overpayments. These activities are done to monitor the cost-effective delivery of Medicaid

services for prudent stewardship of scarce dollars; to assess the required involvement of

professionals in planning care to program beneficiaries; safeguard the quality of care, medicalnecessity and appropriateness of Medicaid services provided; and, to reduce the potential for

fraud, waste and abuse.

DIVISION OF MEDICAID INVESTIGATIONS

The Division of Medicaid Investigations (OM I) investigates potential instances of fraud, waste,

and abuse in the Medicaid program. DMI deters improper behavior by inserting covert and overtinvestigators into all aspects of- the program, scrutinizing provider billing and services, and

cooperating with other agencies to enhance enforcement opportunities. Disreputable providers

are removed from the program or prevented from enrolling. Recipients abusing the system arenot removed from this safety net, but their access to services is examined and restricted, as

appropriate. DMI maximizes cost savings, recoveries, penalties, and improves the quality ofcare for the state's most vulnerable population.

DIVISION OF TECHNOLOGY AND BUSINESS AUTOMATION

The Division of Technology and Business Automation will continue to support the data needs for

the OMIG inthe form of audit and investigative support, data mining and analysis, system match

and recovery, through the use of commercial data mining products and procurement of expertservice consultants.

OFFICE OF COUNSEL TO THE MEDICAID INSPECTOR GENERAL

The Office of Counsel to the Medicaid Inspector General promotes the OMIG's overall statutorymission through timely, accurate and persuasive legal advocacy and counsel.
http://www.omig.ny.gov/http://www.omig.ny.gov/


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EXECUTIVE SUMMARY

BACKGROUND

Pursuant to Title XIX of the Social Security Act, the Medicaid program provides medicalassistance to low-income individuals and individuals with disabilities. The federal and stategovernments jointly fund and administer: the Medicaid program. In New York State, theDepartment of Health (DOH) administers the Medicaid program. As part of this responsibility,the OMIG conducts audits and reviews of various providers of Medicaid reimbursable services,equipment and supplies. These audits and reviews are conducted to determine if the providercomplied with applicable laws, regulations, rules and policies of the Medicaid program as setforth by the Departments of Health and Mental Hygiene [Titles 10, 14 and 18 of the OfficialCompilation of Codes, Rules and Regulations of the State of New York] and the MedicaidProvider Manuals.

Outpatient services provided to persons with developmental disabilities are offered at programslicensed by the Office for People with Developmental Disabilities (OPWDD). The purpose ofthese programs is to offer a comprehensive system of services, which has as its primarypurposes the promotion and attainment of independence, inclusion, and productivity for personswith mental retardation and developmental disabilities. These services are furnished at clinicand day treatment facilities, and through a home and community based Federal waiverprogram. the waiver program, established under the authority of section 1915 [c] of the SocialSecurity Act, is intended for persons with mental retardation and developmental disabilities whowould otherwise need the level of care provided in an intermediate care facility. The specificstandards and criteria for OPWDD services are outlined in Title 14 NYCRR Parts 671, 679, and690.

PURPOSE AND SCOPE

The purpose of this audit was to determine whether the Provider's claims for Medicaidreimbursement for day treatment service complied with applicable federal and state laws,

regulations, rules and policies governing the New York State Medicaid Program. With respectto day treatment service, this audit covered services paid by Medicaid from Janiary 1, 2005,through December 31, 2008.

SUMMARY OF FINDINGS

We inspected a random sample of 100 claims with $35,341.27 in Medicaid payments. Of the100 claims in our random sample, 37 claims had at least one error and did not comply with staterequirements. Of the 37 noncompliant claims, most contained more than one deficiency.Specifics are as follows:

Error DescriptionMissing Physician Review of the Individual Treatment PlanNo Documentation of ServiceMissing Progress NoteIncorrect Rate Code BilledDuration of Service Not DocumentedFailure to Meet Minimum Duration

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Number

of Errors94

24

19

12

7

5


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Based on the procedures performed, the OMIG has determined that the Provider was overpaid

$10,944.77 in sample overpayments with an extrapolated point estimate of $1,737,~82 .. The

lower confidence limit of the amount overpaid is $1,277,133.


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TABLE OF CONTENTS

INTRODUCTION .

BackgroundMedicaid Program 1New York State's Medicaid Program 1New York State's Day Treatment Program 1

Purpose, Scope, and MethodologyPurpose 1Scope 2Methodology 2

LAWS, REGULATIONS, RULES AND POLICIES... 3-4

DETAILED FINDINGS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7

PROVIDER RIGHTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

REMITTANCE ADVICE

ATIACHMENTS:

A - SAMPLE DESIGN AND METHODOLOGY

B - SAMPLE RESULTS AND ESTIMATES

C - DETAILED AUDIT FINDINGS

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INTRODUCTION

BACKGROUND

Medicaid Program

Pursuant to Title XIX of the Social Security Act, the Medicaid program provides medicalassistance to low-income individuals and individuals with disabilities. The Federal and Stategovernments jointly fund and administer the Medicaid program.

New York State's Medicaid Program

In New York State, the Department of Health (DOH) is the State agency responsible foroperating the Medicaid program. Within DOH, the Office of Health Insurance Programsadministers the Medicaid program. DOH uses the electronic Medicaid New York Informationsystem (eMedNY), a computerized payment and information reporting system, to process andpay Medicaid claims, including day treatment service claims.

As part of this responsibility, the OMIG conducts audits and reviews of various providers ofMedicaid reimbursable services, equipment and supplies. These audits and reviews areconducted to determine if the provider complied with applicable laws, regulations, rules andpolicies of the Medicaid program as set forth by the Departments of Health and Mental Hygiene[Titles 10, 14 and 18 of the Official Compilation of Codes, Rules and Regulations of the State ofNew York] and the Medicaid Provider Manuals.

New York State's Day Treatment Service Program

Outpatient services provided to persons with developmental disabilities are offered at programslicensed by the Office for People with Developmental Disabilities (OPWDD). The purpose ofthese programs is to offer a comprehensive system of services, which has as its primary

purposes the promotion and attainment of independence, inclusion, and productivity for personswith mental retardation and developmental disabilities. These services are furnished at clinicand day treatment facilities, and through a home and community based Federal waiverprogram. The waiver program, established under the authority of section 1915 [c] of the SocialSecurity Act, is intended for persons with mehtal retardation and developmental disabilities whowould otherwise need the level of care provided in an intermediate care facility. The specificstandards and criteria for OPWDD services are outlined in Title 14 NYCRR Parts 671,679, and690.

PURPOSE, SCOPE, AND METHODOLOGY

Purpose

The purpose of this audit was to determine whether the Provider's claims for Medicaidreimbursement for day treatment service complied with applicable Federal and State laws,regulations, rules and policies governing the New York State Medicaid Program and to verifythat:

Medicaid reimbursable services were rendered for the dates billed;

appropriate rate or procedure codes were billed for services rendered;

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patient related records contained the documentation required by the regulations;and,

claims for payment were submitted in accordance with DOH regulations and theappropriate Provider Manuals.

Scope

Our audit period covered payments to the Provider for day treatment services paid by Medicaid

from January 1, 2005, through December 31, 2008. Our audit universe consisted of 15,875claims totaling $5,305,805.45.

During our audit, we did not review the overall internal control structure of the Provider. Rather,we limited our internal control review to the objective of our audit.

Methodology

To accomplish our objective, we:

reviewed applicable federal and state laws, regulations, rules and policies;

held discussions with the Provider's management" personnel to gain anunderstanding of the day treatment service program;

ran computer programming application of claims in our data warehouse thatidentified 15,875 paid day treatment service claims, totaling $5,305,805.45;

selected a random sample of 100 claims from the population of 15,875 claims; and,

estimated the overpayment paid in the population of 100 claims.

For each sample selection we inspected, as available, the following:

Medicaid electronic claim information

Individual Day Treatment record, including, but not limited to:o Annual Physicalo Individual Program Plan

o Individual Treatment Plan

o Comprehensive Functional Assessment

o Documentation demonstrating licensed physician review of the individualtreatment plan

o Physical Therapy Documentation

o Occupational Therapy Documentationo Speech Therapy Documentation

o Progress notes

o Treatment Noteso Census Records

Any additional documentation deemed by the Provider necessary to substantiate theMedicaid paid claim

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LAWS, REGULATIONS, RULES AND POLICIES

The following are applicable Laws, Regulations, Rules and Policies of the Medicaid programreferenced when conducting this audit:

Departments of Health and Mental Hygiene [Titles 10, 14, and 18 of the Official

Compilation of Codes, Rules and Regulations of the State of New York (10 NYCRR,14 NYCRR, 18 NYCRR)].

Medicaid Management Information System and eMedNY Provider Manual.

Specifically, Title 14 NYCRR Part 690, and Title 18 NYCRR Parts 360, 504 and 540.

OPWDD Administrative Memorandum #2008-02

In addition to any specific detailed findings, rules and/or regulations which may belisted below, the foflowing regulations pertain to all audits:

Regulations state: "By enrolling the provider agrees: (a) to prepare and to maintaincontemporaneous records demonstrating its right to receive payment ... and to keep

for a period of six years from the date the care, services or supplies were furnished,

all records necessary to disclose the nature and extent of services furnished and all

information regarding claims for payment submitted by, or on behalf .of, theprovider ... (e) to submit claims for payment only for services actually furnished and

which were medically necessary or otherwise authorized under the Social ServicesLaw when furnished and which were provided to eligible persons; (f) to submit claims

on officially authorized claim forms in the manner specified by the department in

conformance with the standards and procedures for claims submission; ... (h) that

the information provided in relation to any claim for payment shall be true, accurate

and complete; and (i) to comply with the rules, regulations and official directives of

the department." 18 NYCRR Section 504.3

Regulations state: "All bills for medical care, services and supplies shall contain:

... (8) a dated certification by the provider that the care, services and suppliesitemized have in fact been furnished; that the amounts listed are due and owing ... ;

that such records as are necessary to disclose .fully the extent of care, services and

supplies provided to individuals under the New York State Medicaid program will bekept for a period of not less than six years from the date of payment ... ; and that the

provider understands that payment and satisfaction of this claim will be from Federal,

State and local public funds and that he or she may be prosecuted under applicable

Federal and State laws for any false claims, statements or documents, orconcealment of a material fact provided .... " 18 NYCRR Section 540.7(a)

Regulations state: "An overpayment includes any amount not authorized to be paid

under the medical assistance program, whether' paid as the result of inaccurate orimproper cost reporting, improper claiming, unacceptable practices, 'fraud, abuse or

mistake." 18 NYCRR Section 518. 1(c)

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Furthermore, according to regulations, all providers must prepare and maintaincontemporaneous records demonstrating their right to receive payment under themedical assistance program. In addition, the provider must keep, for a period of sixyears, all records necessary to disclose the nature and extent of services "furnishedand the medical necessity therefore, including any prescription or fiscal order for the

service or supply. This information is subject to audit for a period of six years andmust be furnished, upon request. 18 NYCRR Section 517.3(b)

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DETAILEDFINDINGS

The OMIG's review of Medicaid claims paid to the Provider from January 1, 2005, throughDecember 31, 2008, identified 37 claims with at least one error, for a total sample overpaymentof $10,944.77 (Attachment C).

Sample Selection

1. Missing Physician Review of the IndividualTreatment Plan

Regulations require that eacn day treatment facilityhave a licensed physician responsible for "reviewingeach person's treatment plan or any substantialrevisions within 30 days of its implementation, andindicating by signature that said treatment plan ...is appropriate andnot medically contraindicated."

14 NYCRR Section 690.5(b)(3)(ii)

In 94 instances pertaining to 15 recipients, thetreatment plan or substantial revisions lacked therequired physician signature.

2. No Documentation of Service

Regulations require that the Medicaid provideragrees, "to prepare and to maintaincontemporaneous records demonstrating its right toreceive payment under the medical assistanceprogram and to keep for a period of six years ... allrecords necessary to disclose the nature and extent

of services furnished ... "18 NYCRR Section 504.3(a)

Regulations also require that bills for medical care,services and supplies contain a certification thatsuch records as are necessary to disclose fully theservices provided to individuals under the New YorkState Medicaid program will be kept for a period ofnot less than six years. These records must befurnished to the Department upon request.

18 NYCRR Section 540.7(a)(8)

Regulations state, "All information regarding claimsfor payment submitted by or on behalf of theprovider is subject to audit,for a period of six yearsfrom the date the care, services or supplies werefurnished or billed, whichever is later, and 'must befurnished, upon request, to the department, the

.Secretary of the United States Department of Healthand Human Services, the Medicaid Fraud ControlUnit or the New York State Department of Health foraudit and review."

18 NYCRR Section 517.3(b)(2)

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9,14,45,46,50,52,58,4,66,69,71, 75, 76, 78 t80, 82, 83, 84, 85,93, 96, 98

1,19,35,47,68,78,92


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In 24 instances pertaining to 6 recipients, recipient

records did not document that a service was

provided.

3. Missing Progress Note

Regulations state, "OPWDD shall verify that

individual program plans of persons admitted to the

day facility include: (1) progress notes describing

the person's response in terms of the established

objectives."

14 NYCRR Section 690.6(s)(1)

In 19 instances pertaining to 4 recipients, the

required progress note was missing.

4. Incorrect RateCode Billed

Regulations state, -"Persons provided day treatment

services in a free-standing certified site or approvedsatellite ... site, will attend for periods in excess of

three hours if reimbursement is to be claimed. Areimbursable half-day visit covers a period of three

to five hours. A full-day reimbursable visit covers aperiod of five hours or more."

14 NYCRR Section 690. 1(d)(1)

In 12 instances' pertaining to 9 recipients, an

incorrect rate code was billed which resulted in a

higher reimbursement than indicated for the properrate code.

5. Duration of Service Not Documented

Regulations state, "The administrator shall maintainor cause to be maintained ... a daily census record,including daily census and cumulative census for

each month and year, accompanied by records

which document and fully detail the extent of

services provided and the length of each service."

14 NYCRR Section 690.5(b)(2)(xv)(b)

Regulations state, "OPWDD shall verify thatindividual program plans -of persons admitted to the

day facility include ... an activity and attendanceschedule."

14 NYCRR Section 690.6(s)(4)

In 7 instances pertaining to 2 recipients, the duration

of the day treatment service was not documented.

The full day visit rate was reduced to a half day visitrate.

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Sample Selection

1, 6, 35, 68, 92

5, 15, 31, 42, 45, 63, 64, 67, 93

35, 78


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6. Failure to Meet Minimum Duration Requirementsfor Non-Collocated Day Treatment Services

Regulations state, "Persons provided day treatmentservices in a free-standing certified site or approved

satellite ... site, will attend for periods in excess ofthree hours if reimbursement is to be claimed."

14 NYCRR Section 690. 1(d)(1)

In 5 instances pertaining to 5 recipients, daytreatment services of less than three hours werebilled.

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Sample Selection

10, 19, 45, 67, 77


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PROVIDER RIGHTS

In accordance with 18 NYCRR Part 518 which regulates the collection of overpayments, your

repayment options are described below. If you decide to repay the lower confidence limit

amount of $1,277,133, one of t~e following repayment options must be selected within 20 daysfrom the date of this letter:

OPTION #1: Make full payment by check or money order within 20 days of the date ofthe final audit report. The check should be made payable to the New York State

Department of Health and be sent with the attached Remittance Advice to:

Mr. David Graber

New York State Department of Health

Medicaid Financial Management

GNARESP Corning Tower, Room 2739

File #10-5762Albany, New York 12237

OPTION #2: Enter into a repayment agreement with the Office of the MedicaidInspector General. If your repayment terms exceed 90 days from the date of the final

audit report, recoveries of amounts due are subject to interest charges at the prime rate

plus 2%. If the process of establishing the repayment agreement exceeds 20 days from

the date of the final audit report, the OMIG will impose a 15% withhold after 20 days untilthe agreement is established.

Furthermore, the OMIG may require financial information from you to establish the terms

of the repayment agreement. If additional information is requested, the OMIG mustreceive the information within 30 days of the request or a 50% withhold will be imposed.

OMIG acceptance of the repayment agreement is based on your repaying the Medicaidoverpayment as agreed. The OMIG will adjust the rate of recovery, or require payment in

full, if your unpaid balance is not being repaid as agreed. The OMIG will notify you nolater than 5 days after initiating such action. If you wish to enter into a repaymentagreement, you must forward your written request within 20 days to the following:

Bureau of Collections ManagementNew York State Office of the Medicaid Inspector General

800 North Pearl StreetAlbany, New York 12204

Phone #: (518) 474-5878

FaX#: (518) 408-0593

If within 20 days, you fail to make full payment or contact the OMIG to make repaymentarrangements, the OMIG will establish a withhold equal to 50% of your Medicaid billingsto recover payment and liquidate the lower confidence limit amount, interest and/orpenalty, not barring any other remedy allowed by law. The OMIG will provide notice toyou no later than 5 days after the withholding of any funds. In addition, if you receive anadjustment in your favor while you owe funds to the State, such adjustment will beapplied against the amount owed.

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If you choose not to settle this audit through repayment of the adjusted lower confidence limit,

you have the right to challenge these findings by requesting an administrative hearing where the

OMIG would seek and defend the point estimate of $1,737,482. As allowed by state

regulations, you must make your request for a hearing, in writing, within sixty (60) days of thedate of this report to:

General CounselOffice of Counsel

New York State Office of the Medicaid Inspector General

800 North Pearl StreetAlbany, New York 12204

Questions regarding the request for a hearing should be directed to Charlene D. Fleszar, Esq.,Office of Counsel, at (518) 408-5811.

Issues you may raise shall be limited to those issues relating to determinations contained in thefinal audit report. Your hearing request may not address issues regarding the methodology

used to determine the rate, or any issue that was raised at a proceeding to appeal a rate

determination.

At the hearing you have the right to:

a) be represented by an attorney or other representative, or to represent yourself;

b) present witnesses and written and/or oral evidence to explain why the action taken iswrong; and

c) cross examine witnesses of the Department of H~alth and/or the OMIG.

The OMIG reserves the right to conduct further reviews of your participation in the Medicaid

Program, take action where appropriate, and recover monies owed through the initiation of acivil lawsuit or other legal mechanisms including but not limited to the recovery of state tax

refunds pursuant to Section 206 of the Public Health Law and Section 171-f of the State TaxLaw.

J

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"NEW YORK STATEOFFICE OF THE MEDICAID INSPECTOR GENERAL

REMITTANCE ADVICE

Ms. Pam CarroadExecutive DirectorUCP of Ulster County Day TreatmentP.O. box 1488Kingston, New York 12402

AUDIT

TYPE

[ X ] PROVIDER[ .1 RATE[ ] PART B

[ ] OTHER:

CHECKLIST

1. To ensure proper credit, please enclose this form with your check.

2. Make checks payable to: New York State Department of Health

3. Record the Audit Number on your check.

4. Mail check to:

Mr. David GraberNew York State Department of Health

Medicaid Financial Management, B.A.M.GNARESP Corning Tower, Room 2739

File #105762Albany, New York 12237

Thank you for your cooperation.


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Attachment A

SAMPLE DESIGN AND METHODOLOGY

Our sample design and methodology are as follows:

Universe - Medicaid claims for day treatment services paid during the periodJanuary 1, 2005, through December 31, 2008.

Sampling Frame - The sampling frame for this objective is the Medicaid electronicdatabase of paid Provider claims for day treatment services paid during the periodJanuary 1, 2005, through December 31, 2008.

Sample Unit - The sample unit is a Medicaid claim paid during the periodJanuary 1, 2005, through December 31, 2008.

Sample Design - Simple sampling was used for sample selection.

Sample Size - The sample size is 100 claims.

Source of Random Numbers - The source of the random numbers was the OMIG

statistical software. We used a random number generator for selecting our randomsampling items.

Characteristics to be measured - Adequacy of documentation received supportingthe sample claims.

Treatment of Missing Sample Services - For purposes of appraising items, anysample service for which the Provider could not produce suffiCient supportingdocumentation was treated as an error.

Estimation Methodology - Estimates are based on the sample data using per unitestimates.


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SAMPLE RESULTS AND ESTIMATES

Universe Size

Sample Size

Sample Book Value

Sample OverpaymentsNet Financial Error Rate

Mean Dollars in Error

Standard Deviation

Point Estimate of Total Dollars

Confidence LevelLower Confidence Limit

15,875

100

$35,341.27$10,944.77

30.969%

$109.4477

175.24$1,737,482

90%

$1,277,133

Attachment B


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ATIACHMENTC

Pagel 019

DETAILED AUDIT FINDINGS


UCP of ULSTER COUNTY

REVIEW OF DAY TREATMENT SERVICES

PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08

Sample Date of Rate Code Amount Over

Number Service Billed Derived Bi ll ed Der ive d Payment

8/21/06 4170 $ 87.76 $ $ 87.76

8/22/06 4170 87.76 87.76

8/23/06 4170 87.76 87.76

8/24/06 4170 87.76 87.76

8/ 25/ 06 4170 87.76 87.76

4/24/06 4170 4170 87.76 87.76

4/25/06 4170 4170 87.76 87.76

4/26/06 4170 4170 87.76 87.76

4/27/06 4170 4170 87.76 87.76

4/28/06 4170 4170 87.76 87.76

10/17/05 4170 4170 87.87 87.87

10/18/05 4170 4170 87.87 87.87

10/19/05 4170 4170 87.87 87.87

10/20/05 4170 4170 87.87 87.87

10/21/05 4170 4170 87.87 87.87

11/7/08 4170 4170 99.27 99.27

12/4/06 4170 4170 90.13 90.13

12/5/06 4170 4171 90.13 45.06 45.06X

12/6/06 4170 4170 90.13 90.13

1217/06 4170 4170 90.13 90.13

12/8/06 4170 4171 90.13 45.07 45.07X

5/29/07 4170 91.47 91.47X

5/30/07 4170 91.47 91.47X

5/31/07 4170 91.47 91.47X

313/06 4170 4170 87.76 87.76

8/1/05 4170 4170 87.87 87.87

12/21/04 4170 87.25 87.25X

12/22/04 4170 87.25 87.25X

12/23/04 4170 87.25 87.25X

10 3/7/05 4170 4170 87.87 87.87

3/8/05 4170 87.87 87.87X

3/9/05 4170 4170 87.87 87.873/10/05 4170 4170 87.87 87.87

3/11/05 4170 4170 87.87 87.87

11 12/1/04 4170 4170 87.25 87.25

12/2/04 4170 4170 87.25 87.25

1213/04 4170 4170 87.25 87.25

12 7/ 16/ 07 4170 4170 94.52 94.52

7/17/07 4170 4170 94.52 94.52

7/18/07 4170 4170 94.52 94.52

7/19/07 4170 4170 94.52 94.52

7/20/07 4170 4170 94.52 94.52

13 11/1/07 4170 4170 94.52 94.52

11/2/07 4170 4170 94.52 94.52


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PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08

Sample Dateof Rate Code Amount Over

Number Service Billed Derived Billed Derived Payment

14 1/27/ 05 4170 $ 87.87 $ $ 87.87X

1/28/ 05 4170 87.87 87.87 X

15 8/25/08 4170 4170 99.27 99.27

8/26/08 4170 4171 99.27 49.64 49.63X

8/27/08 4170 4170 99.27 99.27

8/28/08 4170 4170 99.27 99.27

8/29/ 08 4170 4170 99.27 99.27

16 7/31/08 4170 4170 99.27 99.27

17 5/19/08 4170 4170 94.85 94.85

5/20/08 4170 4170 94.85 94.85

5/21/08 4170 4170 94.85 94.85

5/22/08 4170 4170 94.85 94.85

5/23/08 4170 4170 94.85 94.85

18 5/19/08 4170 4170 94.85 94.85

5/20/08 4170 4170 94.85 94.85

5/21/08 4170 4170 94.85 94.85

5/22/08 4170 4170 94.85 94.85

5/23/08 4170 4170 94.85 94.85

19 8/30/06 4170 87.76 87.76X X

8/31/06 4170 4170 87.76 87.76

20 6/27/05 4170 4170 87.87 87.87

6/28/05 4170 4170 87.87 87.87

6/29/05 4170 4170 87.87 87.87

6/30/05 4170 4170 87.87 87.87

21 6/19/06 4170 4170 87.76 87.76

6/20/ 06 4170 4170 87.76 87.76

6/21/ 06 4170 4170 87.76 87.76

6/22/ 06 4170 4170 87.76 87.76

6/23/ 06 4170 4170 87.76 87.76

22 11nJ05 4170 4170 87.87 87.87

11/8/05 4170 4170 87.87 87.87

1119/05 4170 4170 87.87 87.87

11/10/05 4170 4170 87.87 87.87

11/11/05 4170 4170 87.87 87.87

23 2/5/07 4170 4170 91.47 91.47

2/6/07 4170 4170 91.47 91.47

2nJ07 4170 4170 91.47 91.47

2/8/07 4170 4170 91.47 91.47

219/07 4170 4170 91.47 91.47

24 11nJ05 4170 4170 87.87 87.87

11/8/05 4170 4170 87.87 87.87

1119/05 4170 4170 87.87 87.87

11/10/05 4170 4170 87.87 87.87

11/11/05 4170 4170 87.87 87.87

25 7/11/05 4170 4170 87.87 87.87

ATIACHMENTC

Page 2 019


22/28

A T TA C HM E NT C

P ag e 3 of 9





PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08


Number Service Billed Derived B il le d De ri ve d Payment

7/12/05 4170 4170 $ 87.87 $ 87.87 $

7/13/ 05 4170 4170 87.87 87.87

7/14/ 05 4170 4170 87.87 87.87

7/15/06 4170 4170 87.87 87.87

26 1/28/ 08 4170 4170 102.07 102.07

1/29/08 4170 4170 102.07 102.07

1/30/08 4170 4170 102.07 102.07

1/31/08 4170 4170 102.07 102.07

27 12/26/07 4170 4170 94.52 94.52

12/27/07 4170 4170 94.52 94.52

12/28/07 4170 4170 94.52 94.52

28 4/17/06 4170 4170 87.76 87.76

4/18/06 4170 4170 87.76 87.76

4/19/06 4170 4170 87.76 87.76

4/20/06 4170 4170 87.76 87.76

4/21/06 4170 4170 87.76 87.76

29 1/4/06 4170 4170 87.76 87.76

1/5/06 4170 4170 87.76 87.76

1/6/06 4170 4170 87.76 87.76

30 8/8/05 4170 4170 87.87 87.87

8/9/05 4170 4170 87.87 87.878/10/05 4170 4170 87.87 87.87

8/11/05 4170 4170 87.87 87.87

8/12/05 4170 4170 87.87 87.87

31 8/8/05 4170 4170 87.87 87.87

819/05 4170 4170 87.87 87.87

8/10/05 4170 4171 87.87 43.94 43.93X

8/11/05 4170 4170 87.87 87.87

8/12/05 4170 4170 87.87 87.87

32 10/11/05 4170 4170 87.87 87.87

10/12/05 4170 4170 87.87 87.87

10/13/05 4170 4170 87.87 87.87

10/14/05 4170 4170 87.87 87.87

33 5/1/06 4170 4170 87.76 87.76

5/2/06 4170 4170 87.76 87.76

34 5/19/08 4170 4170 94.85 94.85

5/ 20/ 08 4170 4170 94.85 94.85

5/ 21/ 08 4170 4170 94.85 94.85

5/ 22/ 08 4170 4170 94.85 94.85

5/23/08 4170 4170 94.85 94.85

35 4/18/07 4170 91.47 91.47X X X

4/19/07 4170 91.47 91.47X X X

35 1/ 31/ 05 4170 4170 87.87 87.87

37 10/27/08 4170 4170 99.27 99.27


23/28




PROJECT #10-5762

REVIEW PERIOD:

01/01/05 -12/31/08


Number Service Billed Derived B il le d De ri ve d Payment

10/28/08 4170 4170 $ 99.27 $ 99.27 $

10/29/08 4170 4170 99.27 99.27

10/30108 4170 4170 99.27 99.27

10/31/08 4170 4170 99.27 99.27

38 1/4/07 4170 4170 100.14 100.14

1/5/07 4170 4170 100.14 100.14

39 9/17/07 4170 4170 94.52 94.52

9/18/07 4170 4170 94.52 94.52

9/19/07 4170 4170 94.52 94.529/20/07 4170 4170 94.52 94.52

9/21/07 4170 4170 94.52 94.52

40 5/22/06 4170 4170 87.76 87.76

5/23/06 4170 4170 87.76 87.76

5/24/06 4170 4170 87.76 87.76

5/25/06 4170 4170 87.76 87.76

5/26/05 4170 4170 87.76 87.76

41 1/30/06 4170 4170 87.76 87.76

1/31/06 4170 4170 87.76 87.76

42 11/26/07 4170 4170 94.52 94.52

11/27/07 4170 4170 94.52 94.52

11/28/07 4170 4170 94.52 94.52

11/29/07 4170 4171 94.52 47.26 47.26X

11/30/07 4170 4171 94.52 47.26 47.26X

43 8/18/05 4170 4170 87.87 87.87

8/19/05 4170 4170 87.87 87.87

44 817108 4170 4170 99.27 99.27

8/8/08 4170 4170 99.27 99.27

45 6/6/05 4170 87.87 87.87X

617105 4170 87.87 87.87 X X X

6/8/05 4170 87.87 87.87 X

6/9/05 4170 87.87 87.87 X X

6/10/05 4170 87.87 87.87 X

46 10/16/06 4170 90.13 90.13 X

10/17/06 4170 90.13 90.13 X

10/18/06 4170 90.13 90.13 X

10/19/06 4170 90.13 90.13 X

47 7/5/07 4170 94.52 94.52X

7/6/07 4170 94.52 94.52 X

48 6/6/05 4170 4170 87.87 87.87

617108 4170 4170 87.87 87.87

6/8/05 4170 4170 87.87 87.87

6/9/05 4170 4170 87.87 87.87

6/10/05 4170 4170 87.87 87.87

A T TA C HM E NT C

Page 4 019


24/28




PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08


Number Service Billed Der iv ed B il led Derived Payment

49 10/9/07 4170 4170 $ 94.52 $ 94.52 $

10/10/07 4170 4170 94.52 94.52

50 10/15/07 4170 94.52 94.52X

10/16/07 4170 94.52 94.52X

10/17/07 4170 94.52 94.52X

10/18/07 4170 94.52 94.52X

51 6/1/07 4170 4170 91.47 91.47

52 5/21/07 4170 91.47 91.47X

5/22/ 07 4170 91.47 91.47X

5/23/07 4170 91.47 91.47X

5/24/07 4170 91.47 91.47X

5/25/07 4170 91.47 91.47X

53 3/28/05 4170 4170 87.87 87.87

3/29/05 4170 4170 87.87 87.87

3/30/05 4170 4170 87.87 87.87

3/31/05 4170 4170 87.87 87.87

54 7/5/05 4170 4170 87.87 87.87

55 1/22/08 4170 4170 102.07 102.07

1/23/08 4170 4170 102.07 102.07

1/24/08 4170 4170 102.07 102.07

1/25/08 4170 4170 102.07 102.07

56 11/21/05 4170 4170 87.87 87.87

11/22/05 4170 4170 87.87 87.87

11/23/05 4170 4170 87.87 87.87

57 5/12/08 4170 4170 94.85 94.85

5/13/08 4170 4170 94.85 94.85

5/14/08 4170 4170 94.85 94.85

5/15/08 4170 4170 94.85 94.85

58 3/12/08 4170 93.94 93.94X

3/13/08 4170 93.94 93.94X

3/14/08 4170 93.94 93.94X

59 12/26/06 4170 4170 90.13 90.13

12/27/06 4170 4170 90.13 90.13

12/28/06 4170 4170 90.13 90.13

12/29/06 4170 4170 90.13 90.13

60 2/1/07 4170 4170 91.47 91.47

2/2/07 4170 4170 91.47 91.47

61 7/5/05 4170 4170 87.87 87.87

7/6/05 4170 4170 87.87 87.87

7/7/05 4170 4170 87.87 87.87

7/8/05 4170 4170 87.87 87.87

62 9/22/08 4170 4170 99.27 99.27

9/23/08 4170 4170 99.27 99.27

9/24/08 4170 4170 99.27 99.27

ATIACHMENTC

Page 5 of9


25/28

ATIACHMENTC

Page 6 of9





PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08



9/25/08 4170 4170 $ 99.27 $ 99.27 $

9/26/08 4170 4170 99.27 99.27

63 12/15/08 4170 4170 99.27 99.27

12/16/08 4170 4170 99.27 99.27

12/17/08 4170 4170 99.27 99.27

12/18/08 4170 4170 99.27 99.27

12/19/08 4170 4171 99.27 49.64 49.63X

64 8/25/08 4170 99.27 99.27X X

8/26/08 4170 99.2799.27 X

8/27/08 4170 99.27 99.27X

8/28/08 4170 99.27 99.27X

8/29/08 4170 99.27 99.27X

65 1/10/05 4170 4170 87.87 87.87

1/10/05 4170 4170 87.87 87.87

66 9/2/08 4170 4170 99.27 99.27X

9/3/08 4170 4170 99.27 99.27X

9/4/08 4170 4170 99.27 99.27X

9/5/08 4170 4170 99.27 99.27X

67 11/6/06 4170 4170 90.13 90.13

11/7/06 4170 90.13 90.13X X

11/8/06 4170 4170 90.13 90.13

1119/06 4170 4170 90.13 90.13

11/10/06 4170 4170 90.13 90.13

68 5/16/05 4170 87.87 87.87X X

5/17/05 4170 87.87 87.87X X

5/18/05 4170 87.87 87.87X X

5/19/05 4170 87.87 87.87X X

5/20/05 4170 87.87 87.87X X

69 11/3/08 4170 99.27 99.27X

11/4/08 4170 99.27 99.27 X

11/5/08 4170 99.27 99.27X

11/6/08 4170 99.27 99.27X

11/7/08 4170 99.27 99.27X

70 8/29/05 4170 4170 87.87 87.87

8/30/05 4170 4170 87.87 87.87

8/31/05 4170 4170 87.87 87.87

71 5/1/06 4170 87.76 87.76X

5/2/06 4170 87.76 87.76 X

5/3/06 4170 87.76 87.76 X

5/4/06 4170 87.76 87.76X

5/5/06 4170' 87.76 87.76 X

72 8/28/06 4170 4170 87.76 87.76

8/29/06 4170 4170 87.76 87.76

8/30/06 4170 4170 87.76 87.76

8/31/06 4170 4170 87.76 87.76


26/28

ATTACHMENT C

Paga 7 019





PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08

Sample Dale of Rale Code Amount Over


73 8/8/05 4170 4170 $ 87.87 $ 87.87 $

8/9/05 4170 4170 87.87 87.87

8/10/05 4170 4170 87.87 87.87

8/11/ 05 4170 4170 87.87 87.87

8/12/ 05 4170 4170 87.87 87.87

74 6/13/05 4170 4170 87.87 87.87

6/14/05 4170 4170 87.87 87.87

6/15/05 4170 4170 87.87 87.87

6/16/05 4170 4170 87.87 87.87

6/17/05 41704170 87.87 87.87

75 10/14/08 4170 99.27 99.27X

10/15/08 4170 99.27 99.27X

10/16/08 4170 99.27 99.27X

10/17/08 4170 99.27 - 99.27X

76 10/2/06 4170 90.13 90.13X

1013/06 4170 90.13 90.13X

10/4/06 4170 90.13 90.13 X

10/5/06 4170 90.13 90.13X

10/6/06 4170 90.13 90.13X

77 4/21/08 4170 4170 94.85 94.85

4/22/08 4170 4170 94.85 94.85

4/23/08 4170 4170 94.85 94.85

4/24/08 4170 94.8594.85 X

4/25/08 4170 4170 94.85 94.85

78 3/7/05 4170 87.87 87.87X X X

3/8/05 4170 87.87 87.87X X X

319/05 4170 87.87 87.87X X X

3/10/05 4170 87.87 87.87X X X

3/11/ 05 4170 87.87 87.87 X XX

79 9/26/05 4170 4170 87.87 87.87

9/27/05 4170 4170 87.87 87.87

9/28/05 4170 4170 87.87 87.87

9/29/05 4170 4170 87.87 87.87

9/30/05 4170 4170 87.87 87.87

80 2/1/06 4170 87.76 87.76 X

2/2/06 4170 87.76 87.76X

2/3/06 4170 87.76 87.76X

81 4/5/05 4170 4170 87.87 87.87

4/6/05 4170 4170 87.87 87.87

4/7/05 4170 4170 87.87 87.87

4/8/05 4170 4170 87.87 87.87

82 10/10/06 4170 90.13 90.13X

10/11/06 4170 90.13 90.13X

10/12/06 . 4170 90.13 90.13X

10/13/06 4170 90.13 90.13X

83 11/10/08 4170 99.27 99.27X

11/11/08 4170 99.27 99.27 X


27/28




PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08



11/12/08 4170 $ 99.27 $ $ 99.27 X

11/13/08 4170 99.27 99.27X

11/14/08 4170 99.27 99.27X

54 6/4/07 4170 91.47 91.47X

6/5/07 4170 91.47 91.47X

6/6/07 4170 91.47 91.47X

6/7/07 4170 91.47 91.47X

6/8/07 4170 91.47 91.47X

85 1/14/08 4170102.07 102.07 X

1/15/08 4170 102.07 102.07X

1/16/08 4170 102.07 102.07X

1/17/08 4170 102.07 102.07X

1/18/08 4170 102.07 102.07X

86 10/6/08 4170 4170 99.27 99.27

10/7/08 4170 4170 99.27 99.27

10/8/08 4170 4170 99.27 99.27

87 6/13/05 4170 4170 87.87 87.87

6/14/05 4170 4170 87.87 87.87

6/15/05 4170 4170 87.87 87.87

6/16/05 4170 4170 87.87 87.87

6/17/05 4170 4170 87.87 87.87

88 3/26/07 4170 4170 91.47 91.47

3/ 27/ 07 4 170 4170 91.47 91.47

3/28/07 4170 4170 91.47 91.47

3/29/07 4170 4170 91.47 91.47

3130/07 4170 4170 91.47 91.47

89 9/17/07 4170 4170 94.52 94.52

9/18/07 4170 4170 94.52 94.52

9/19/07 4170 4170 94.52 94.52

9/20/07 4170 4170 94.52 94.52

9/21/07 4170 4170 94.52 94.52

90 8/8/05 4170 4170 87.87 87.87

8/9/05 4170 4170 87.87 87.87

8/10/05 4170 4170 87.87 87.87

8/11/05 4170 4170 87.87 87.87

8/ 12/ 05 4170 4170 87.87 87.87

91 4/7/08 4170 4170 94.85 94.85

92 5/2/05 4170 87.87 87.87X X

513/05 4170 87.87 87.87X X

5/4/05 4170 87.87 87.87X X

5/5/05 4170 .87.87 87.87X X

93 10/27/08 4170 99.27 99.27X X

10/28/08 4170 99.27 99.27 X

10/29/08 4170 99.27 99.27 X

10/30/08 4170 99.27 99.27 X


ATTACHMENT C

Page 8 of9


28/28

ATIACHMENTC

Page 9 019



UCP ofULSTER COUNTY


PROJECT #10-5762

REVIEW PERIOD:

01/01/05 - 12/31/08



10/31/08 4170 $ 99.27 $ $ 99.27 X

94 9/ 14/ 05 4170 4170 87.87 87.87

9/15/05 4170 4170 87.87 87.87

9/ 16/ 05 4170 4170 87.87 87.87

95 11/26/07 4170 4170 94.52 94.52

11/27/07 4170 4170 94.52 94.52

11/28/07 4170 4170 94.52 94.52

11/29/07 4170 4170 94.52 94.52

11/30/07 4170 4170 94.5294.52

96 12/26/07 4170 94.52 94.52X

12/27/07 4170 94.52 94.52X

12/28/07 4170 94.52 94.52X

97 3/17/06 4170 4170 87.76 87.76

98 4/11/05 4170 87.87 87.87X

4/12/05 4170 87.87 87.87 X

4/13/05 4170 87.87 87.87 X

4/14/05 4170 87.87 87.87 X

4/15/06 4170 87.87 87.87X

99 7/14/08, 4170 4170 99.27 99.27

7/ 15/ 08 4170 4170 99.27 99.27

7/ 16/ 08 4170 4170 99.27 99.27

7/17/08 4170 4170 99.27 99.27

7/ 18/ 08 4170 4170 99.27 99.27

100 5/ 23/ 05 4170 4170 87.87 87.87

5/ 24/ 05 4170 4170 87.87 87.87

5/25/05 4170 4170 87.87 87.87

5/26/05 4170 4170 87.87 87.87

5/27/05 4170 4170 87.87 87.87

Totals $ 35,341.27 $ 24,396.50 $ 10,944.77 94 24 19 12 7 5

ulster county ucp audit 1

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