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DiNapoli: Former Medical Office Manager Arrested for Scheme to Defraud the New York State Health Insurance Plan
… DiNapoli, Ulster County District Attorney Clegg, and the FBI Hudson Valley White Collar Crime Task Force. “Gina Bradshaw allegedly took … in court on October 11, 2023. The charges filed in this case are merely accusations and the defendant is presumed …
https://www.osc.ny.gov/press/releases/2023/09/dinapoli-former-medical-office-manager-arrested-scheme-defraud-new-york-state-health-insurance-planIX.12.Q Annual ALN (Assistance Listing Number) Confirmation for Schedule of Expenditures of Federal and Non-Cash Awards – IX. Federal Grants
… of Financial Reporting and Oil Spill Remediation will contact certain state agencies to confirm that disbursements … of Financial Reporting and Oil Spill Remediation will contact certain state agencies to confirm that disbursements …
https://www.osc.ny.gov/state-agencies/gfo/chapter-ix/ix12q-annual-cfda-confirmation-schedule-expenditures-federal-and-non-cash-awardsDiNapoli Op-Ed in the NY Daily News Cautions NYC Leaders to Prepare for Challenging Fiscal Times Ahead
… against the challenges that lie ahead. The full op-ed is below: In the last 20 years, New York City has had to … now a global pandemic. Looking forward, the only certainty is that the city will face uncertainty in the months and years to come. Predicting the city’s fiscal future is problematic. We still don’t know the shape of the economic …
https://www.osc.ny.gov/press/releases/2021/09/dinapoli-op-ed-ny-daily-news-cautions-nyc-leaders-prepare-challenging-fiscal-times-aheadDiNapoli: Former Tax Collector Accused of Pocketing $88,000 for Car Loans, Amazon Purchases, Food and Other Expenses
… N.Y., for allegedly stealing more than $88,000 in tax funds collected for the use of the town of Beekman and … Comptroller DiNapoli said. “Taxpayers expect their tax money to benefit their community, not to pay for an … Police Acting Superintendent Kevin P. Bruen. “This former tax collector took money from taxpayers for her own personal …
https://www.osc.ny.gov/press/releases/2021/03/dinapoli-former-tax-collector-accused-pocketing-88000-car-loans-amazon-purchases-food-and-otherMedicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
… and excessive Medicaid payments to clinics and outpatient facil …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-ambulatory-patient-groups-payments-duplicate-claims-and-services-excessMedicaid Program – Improper Payments for Recipients No Longer Enrolled in Managed Long Term Care Partial Capitation Plans
… Purpose To determine whether the Medicaid program made inappropriate capitation payments to Managed Long Term Care Partial Capitation plans for … To determine whether the Medicaid program made inappropriate …
https://www.osc.ny.gov/state-agencies/audits/2016/03/30/medicaid-program-improper-payments-recipients-no-longer-enrolled-managed-long-term-careSelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… if BlueCross BlueShield’s (Empire’s) payments to Arden Hill Hospital (Arden Hill) for special items were made according to the provisions of the agreement between Empire and Arden Hill. Background The New York State Health Insurance Program … if BlueCross BlueShields Empires payments to Arden Hill Hospital Arden Hill for special items were made …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-arden-hill-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to St. Mary's Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield’s (Empire’s) payments to St. Mary’s Hospital (St. Mary’s) for special items were made according to the provisions of the agreement between Empire and St. Mary’s. Background The New York State Health Insurance … To determine if BlueCross BlueShields Empires payments to St Marys Hospital St Marys for special items were made …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011Selected Payments for Special Items Made to Albany Medical Center from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield’s (Empire’s) payments to Albany Medical Center (AMC) for special items were made … To determine if BlueCross BlueShields Empires payments to Albany Medical Center AMC for special items were made …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-albany-medical-center-january-1-2011-through-march-31Selected Payments for Special Items Made to Mount Sinai Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield's (Empire's) payments to Mount Sinai Hospital (Mount Sinai) for special items were made according to the provisions of the agreement between Empire and Mount Sinai. Background The New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-mount-sinai-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to St. Peter's Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield's (Empire's) payments to St. Peter's Hospital (St. Peter's) for special items were made according to the provisions of the agreement between Empire and St. Peter's. Background The New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Assessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… to Administer the Workers’ Compensation Program for the Two Fiscal Years Ended March 31, 2013 (2014-S-43) Workers’ …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Identifying, Reporting, and Providing Services for Youth at Risk of Sexual Human Trafficking in New York City
… Objective To determine if the New York City Administration for Children’s Services and the New York City Department of Youth and Community Development identify, report on, and … To determine if the New York City Administration for Childrens Services and the New York City Department of …
https://www.osc.ny.gov/state-agencies/audits/2022/06/06/identifying-reporting-and-providing-services-youth-risk-sexual-human-trafficking-new-yorkMedicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… Objective To determine whether Medicaid overpayments for pharmacy … enrolled recipient, and in turn, the MCOs are required to pay for the Medicaid services their recipients require, … have other third-party health insurance (TPHI) in addition to Medicaid (e.g., employer-based coverage or Medicare Part …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsNew York City Department of Homeless Services – Oversight of Contract Expenditures of Institute for Community Living, Inc.
… substance abuse disorders at their 200-bed Tillary Street Women’s Shelter (Tillary) for the period from December … for a total of $35.6 million during the 2015-16 to 2019-20 fiscal years to an aggregate cost of approximately $50.8 …
https://www.osc.ny.gov/state-agencies/audits/2022/09/16/new-york-city-department-homeless-services-oversight-contract-expenditures-instituteSelected Aspects of Leasing Practices for Real Estate Department, Aviation, World Trade Center, and Leasing of Properties
… This audit covered the period January 1, 2014 through November 21, 2019. About the Program PANYNJ was created to … November 2019. This amount included money due to PANYNJ for utilities, amounts due when tenants terminated their … for sale and advertisement pricing, and consider obtaining direct access to the vendor’s system to support monitoring of …
https://www.osc.ny.gov/state-agencies/audits/2021/05/04/selected-aspects-leasing-practices-real-estate-department-aviation-world-trade-center-andMedicaid Program – Improper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements
… Objective To determine whether the Department of Health (Department) … Medicaid program provides a wide range of medical services to those who are economically disadvantaged and/or have … services through the Medicaid fee-for-service program to be enrolled as participating providers and their NPIs to …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-claims-not-compliance-ordering-prescribingInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… made in our initial audit report, Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care … program. Managed care plans (Plans) receive monthly premium payments for individuals enrolled in their plans. The … made in our initial audit report Inappropriate Premium Payments for Recipients No Longer …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… Objective To assess the extent of implementation of the four … recipients are enrolled in Medicare and are referred to as “dual-eligibles.” Additionally, many Medicaid … and Recovery Plans (HARP), which provide specialized care to recipients aged 21 or older with serious mental illness …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… (MCOs) a monthly premium for each enrolled recipient. In turn, the MCOs are required to pay for the services their … recipients have other third-party health insurance (TPHI) in addition to Medicaid (e.g., employer-based coverage or … provider reviews for the recovery of $52.2 million in inpatient claims where MCOs paid as the primary insurance …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipients