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Improper Medicaid Payments to Hospitals for Outpatient Services Billed as Inpatient Services for Recipients Enrolled in Managed Care
… through June 2023. About the Program The Department of Health (DOH) administers the Medicaid program. Most of the … 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-servicesDiNapoli's Auditors Halt $24.2 Million in Suspicious Tax Refunds
… York State Comptroller Thomas P. DiNapoli announced today his office stopped $24.2 million in questionable or … 2018. "Tax cheats are continuously looking for new ways to beat the system, but my auditors are staying one step ahead … DiNapoli's office include the use of questionable social security numbers and intentionally misstating deductions. …
https://www.osc.ny.gov/press/releases/2018/04/dinapolis-auditors-halt-242-million-suspicious-tax-refundsSelected Aspects of Parking Violations Operations to Collect Fines and Fees (Follow-Up)
… of implementation of the 11 recommendations included in our initial audit report, Selected Aspects of Parking … either in person, using an Internet application, or by mail. If found guilty by an ALJ, the vehicle owner is … of: 528,545 in-person hearings, 899,021 hearings by mail, and 1,771,868 online hearings. For vehicle owners who …
https://www.osc.ny.gov/state-agencies/audits/2022/01/06/selected-aspects-parking-violations-operations-collect-fines-and-fees-followSecurity Delivery Instructions
… be delivered via ACATS to: Wells Fargo Clearing Services, LLC ACATS Participant #0141 Reference: State of New York, OUF …
https://www.osc.ny.gov/unclaimed-funds/reporters/security-delivery-instructionsIrvington Union Free School District – Information Technology (2016M-266)
… The Irvington Union Free School District is located in the Towns of Greenburgh and Tarrytown and the Village of … allows for the use of personal email through external mail servers. District staff are able to access websites that … allowing users to access personal email through external mail servers and amend the email policy accordingly. Monitor …
https://www.osc.ny.gov/local-government/audits/school-district/2016/11/18/irvington-union-free-school-district-information-technology-2016m-266Edwards-Knox Central School District – Medicaid Reimbursements (2021M-92)
… which it was entitled. Key Findings The District did not claim any Medicaid reimbursements to which it was entitled. District officials: Did not claim Medicaid reimbursements for the 12 students we … it is not cost-effective. Did not establish Medicaid claim policies or procedures or ensure that sufficient …
https://www.osc.ny.gov/local-government/audits/school-district/2021/08/20/edwards-knox-central-school-district-medicaid-reimbursements-2021m-92Opinion 92-24
… at least weekly for at least one year; (3) contain news, editorials and other matters of "current interest"; (4) …
https://www.osc.ny.gov/legal-opinions/opinion-92-24Town of Owasco – Highway Department (2020M-128)
… whether Town of Owasco (Town) officials adequately oversaw highway purchasing, planning and interfund charges. Key Findings Town officials did not adequately oversee highway purchasing, planning and interfund charges. We found 596 highway claims totaling $349,824 that did not have an …
https://www.osc.ny.gov/local-government/audits/town/2021/05/28/town-owasco-highway-department-2020m-128Contract #C001204 – Electronic Fillable Form Creation & Hosting Services
… State Comptroller (“OSC”) is seeking Electronic Fillable Form Creation & Hosting Services. All details and … A (Scope of Work) , in PDF Attachment B (Response Form) , in Word Attachment B-1 (Solution Requirements Matrix) …
https://www.osc.ny.gov/procurement/contract-c001204State Agencies Bulletin No. 1217.1
… and Settlement Agreements in the State Payroll System. COU (Court Order) – To be used for all Job Data Actions … must use the Action/Reason codes of REH (Rehire) and COU (Court Order). AWD (Award) – To be used for all Job …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/12171-new-requirements-and-procedures-processing-salary-payments-pursuantState Agencies Bulletin No. 1217
… and Settlement Agreements in the State Payroll System. COU (Court Order) – To be used for all Job Data Actions (Pay, … must use the Action/Reason codes of REH (Rehire) and COU (Court Order). AWD (Award) – To be used for all Job Data …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1217-new-requirements-and-procedures-processing-salary-payments-pursuantDiNapoli: Audit Finds More Than $16 Million in Medicaid Cost Savings
… and our latest audit is no exception. The Department of Health should continue its efforts to recoup questionable … who are economically disadvantaged or have special health care needs. DOH's eMedNY computer system processes Medicaid … that certain actions have been and will be taken to address them. DOH's full response is included in the complete …
https://www.osc.ny.gov/press/releases/2017/07/dinapoli-audit-finds-more-16-million-medicaid-cost-savingsMedicaid Program – Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus
… premium payments to Medicaid mainstream managed care plans and Family Health Plus managed care plans (Plans) … Our audit covered the period October 1, 2010 through September 30, 2016. Background Under the Department’s managed … Medicaid program. For the period October 1, 2010 through September 30, 2016, the Department paid Plans approximately …
https://www.osc.ny.gov/state-agencies/audits/2017/07/11/medicaid-program-inappropriate-premium-payments-recipients-no-longer-enrolled-mainstreamUnited HealthCare – Overpayments for Services Provided by Long Island Bone and Joint, LLP
… Purpose To determine whether Long Island Bone and Joint, LLP waived Empire Plan members’ … the period January 1, 2011 through October 31, 2015. On one claim, for example, LI Bone and Joint charged $9,400 and, …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/united-healthcare-overpayments-services-provided-long-island-bone-and-joint-llpOpinion 88-71
… (see City of Mount Vernon v Mount Vernon Trust Co. , 270 NY 400, 1 NE2d 825). Moreover, it has been held that the … Misc 219, 55 NYS 50, affd 40 App Div 331, 57 NYS 1039, 160 NY 691). There is sufficient consideration for the compromise … ( O'Brien v City of New York , supra ; see also City of Rochester v Chiarella , 121 Misc 2d 257, 467 NYS2d 948, affd …
https://www.osc.ny.gov/legal-opinions/opinion-88-71Granville Central School District – Medicaid Reimbursements (2021M-90)
Determine whether the Granville Central School District District maximized Medicaid reimbursements by claiming for all eligible Medicaid services provided
https://www.osc.ny.gov/local-government/audits/school-district/2021/08/27/granville-central-school-district-medicaid-reimbursements-2021m-90College of Staten Island - Examination of Fast Track MK LLC
… The objective of our examination was to determine if the College conducted an appropriate procurement for the goods … Law. Specifically, the College did not: (i) reject quotes from offerers that did not comply with mandatory …
https://www.osc.ny.gov/state-agencies/audits/2016/02/05/college-staten-island-examination-fast-track-mk-llcWaiver Request Form
To request a waiver from completing publication activities relative to your abandoned property filing as described in Section 1411 of the New York State Abandon
https://www.osc.ny.gov/files/unclaimed-funds/reporters/pdf/waiver-request.pdfMedicaid Program – Medicaid Claims Processing Activity October 1, 2012 Through March 31, 2013
… Purpose To determine whether the Department of Health's eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were processed … Department of Health (Department) administers the State's Medicaid program. The Department's eMedNY computer system …
https://www.osc.ny.gov/state-agencies/audits/2014/05/22/medicaid-program-medicaid-claims-processing-activity-october-1-2012-through-march-31-2013Westchester Attorney Indicted for Fraud and False Statement Charges Arising From His Attempt to Embezzle From a Decedent's Estate for Which He Was Court-Appointed Administrator
… White Plains Division. Assistant United States Attorney James McMahon is in charge of the prosecution. The charges …
https://www.osc.ny.gov/press/releases/2018/08/westchester-attorney-indicted-fraud-and-false-statement-charges-arising-his-attempt-embezzle