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DiNapoli: Former Medical Office Manager Arrested for Scheme to Defraud the New York State Health Insurance Plan
… New York State Comptroller Thomas P. DiNapoli, announced the arrest yesterday of Gina Bradshaw, an officer manager for … for her alleged role in a long-term scheme to defraud the New York State Insurance Plan (NYSHIP) out of over … $12,000 by submitting fraudulent claims for reimbursement. The arrest was the result of a joint investigation between …
https://www.osc.ny.gov/press/releases/2023/09/dinapoli-former-medical-office-manager-arrested-scheme-defraud-new-york-state-health-insurance-planDiNapoli: Former Throop Supervisor Pays Full Restitution After Pleading Guilty to Felony for Stealing $11,000 from Town
… Comptroller Thomas P. DiNapoli, Attorney General Letitia James, and the New York State Police announced today. William … personal gain,” DiNapoli said. “I thank Attorney General James and the New York State Police for their work in …
https://www.osc.ny.gov/press/releases/2024/02/dinapoli-former-throop-supervisor-pays-full-restitution-after-pleading-guilty-felony-stealing-11000Selected Payments for Special Items Made to St. Mary's Hospital from January 1, 2011 through March 31, 2011
… (Empire’s) payments to St. Mary’s Hospital (St. Mary’s) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011Medicaid 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 services on behalf of managed care recipients … pays managed care organizations (MCOs) a monthly premium for each enrolled recipient, and in turn, the MCOs are required to pay for the Medicaid services their recipients require, which …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsSelected Payments for Special Items Made to St. Peter's Hospital from January 1, 2011 through March 31, 2011
… to the provisions of the agreement between Empire and St. Peter's. Background The New York State Health … (NYSHIP) provides health insurance coverage to active and retired State, participating local government and school district employees and their dependents. The …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to Mount Sinai Hospital from January 1, 2011 through March 31, 2011
… to the provisions of the agreement between Empire and Mount Sinai. Background The New York State Health … (NYSHIP) provides health insurance coverage to active and retired State, participating local government and school district employees and their dependents. The …
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 Albany Medical Center from January 1, 2011 through March 31, 2011
… (Empire’s) payments to Albany Medical Center (AMC) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-albany-medical-center-january-1-2011-through-march-31Identifying, Reporting, and Providing Services for Youth at Risk of Sexual Human Trafficking in New York City
… (NYC) reported an average of just 2,249 such children each year for the 4-year period of January 2017 through December … (OCFS) issued Administrative Directive 15-OCFS-ADM-16: Requirements to Identify, Document, Report and Provide … providers comply with Administrative Directive 15-OCFS-ADM-16 and are adequately trained to identify, report on, and …
https://www.osc.ny.gov/state-agencies/audits/2022/06/06/identifying-reporting-and-providing-services-youth-risk-sexual-human-trafficking-new-yorkSelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… to the provisions of the agreement between Empire and Arden Hill. Background The New York State Health … (NYSHIP) provides health insurance coverage to active and retired State, participating local government and school district employees and their dependents. The …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-arden-hill-hospital-january-1-2011-through-march-31Medicaid Program – Improper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements
… whether the Department of Health (Department) paid for claims in violation of federal and State regulations that … require an appropriate National Provider Identifier (NPI) for ordering, prescribing, referring, and attending (OPRA) … disadvantaged and/or have special health care needs. For the State fiscal year ended March 31, 2020, New York’s …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-claims-not-compliance-ordering-prescribingDiNapoli: 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 its … deliveries from Gobble Meals. She also used taxpayers’ funds to make car loan payments. She served as Beekman tax … Junction NY for allegedly stealing more than $88000 in tax funds collected for the use of the town of Beekman and its …
https://www.osc.ny.gov/press/releases/2021/03/dinapoli-former-tax-collector-accused-pocketing-88000-car-loans-amazon-purchases-food-and-otherSelected Aspects of Leasing Practices for Real Estate Department, Aviation, World Trade Center, and Leasing of Properties
… of two sampled airport system leases, we found that a property leased from a municipality for future development of … notified the municipality of this sub-lease and paid real property taxes. The other lease was for a garage as part of … are properly notified of the property uses and of PANYNJ’s tax-exempt status. … To determine whether the Port Authority …
https://www.osc.ny.gov/state-agencies/audits/2021/05/04/selected-aspects-leasing-practices-real-estate-department-aviation-world-trade-center-andDiNapoli: 33.55 Percent Annual Investment Return for New York State Pension Fund Is Largest in Its History
… The return on investments increased the Fund’s value to an estimated $254.8 billion. “The state pension fund rode … ever. With our talented investment staff, I will continue to manage our state’s pension fund with prudence and a focus … retirement security for our members for generations to come.” The Fund's value reflects retirement and death …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-33-point-55-percent-annual-investment-return-new-york-state-pension-fund-largest-its-historyInappropriate 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 … program. Managed care plans (Plans) receive monthly premium payments for individuals enrolled in their plans. The … Department of Health (Department) has the right to recover premium payments from Plans for inappropriately enrolled …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andDiNapoli Op-Ed in the NY Daily News Cautions NYC Leaders to Prepare for Challenging Fiscal Times Ahead
… show they are a necessity in an uncertain world. Even with FEMA aid, recovering from Ida’s flooding will require a … events. The city has less in reserves today to deal with, and prepare for, the unexpected than it did during the …
https://www.osc.ny.gov/press/releases/2021/09/dinapoli-op-ed-ny-daily-news-cautions-nyc-leaders-prepare-challenging-fiscal-times-aheadDiNapoli: Queens Woman Charged With Stealing Nearly $85,000 in NYS Pension Payments Meant for Her Deceased Father
… condominium, where she resided. She allegedly spent other funds from the account on personal expenses. Deanna Hansen … banking information to access the account and transfer funds to her own account and to pay the condo management …
https://www.osc.ny.gov/press/releases/2024/05/dinapoli-queens-woman-charged-stealing-nearly-85000-nys-pension-payments-meant-her-deceased-fatherDiNapoli: Queens Woman Pleads Guilty to Stealing $85,000 in NYS Pension Payments Meant for Her Deceased Father
… the toll-free Fraud Hotline at 1-888-672-4555, by filing a complaint online at https://www.osc.ny.gov/investigations , or by mailing a complaint to: Office of the State Comptroller, Division of …
https://www.osc.ny.gov/press/releases/2024/06/dinapoli-queens-woman-pleads-guilty-stealing-85000-nys-pension-payments-meant-her-deceased-fatherExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… in our initial audit report, Excessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed … disorders. Within MMC and HARP is the Integrated Benefits for Dually Eligible Enrollees Program (IB-Dual), which became … 1, 2021. IB-Dual pays lower MMC and HARP premium rates for Medicaid recipients in MMC or HARP who enroll in Medicare …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andNew York City Department of Homeless Services – Oversight of Contract Expenditures of Institute for Community Living, Inc.
… allowable, supported, and program related. To qualify for reimbursement, ICL’s invoices/expenses must comply with DHS’ … and DHS staff members to ensure that they are aware of the reimbursement requirements. … To determine whether the New …
https://www.osc.ny.gov/state-agencies/audits/2022/09/16/new-york-city-department-homeless-services-oversight-contract-expenditures-instituteDiNapoli: New York City Man Charged with Stealing Over $50,000 in Pension Benefits Meant for Deceased Sister-in-Law
… in pension benefits meant for his deceased sister-in-law, New York State Comptroller Thomas P. DiNapoli announced. … She retired choosing the state retirement system’s single life allowance option, meaning at the time of her death in … by filing a complaint online at investigations@osc.ny.gov , or by mailing a complaint to: Office of the State …
https://www.osc.ny.gov/press/releases/2024/09/dinapoli-new-york-city-man-charged-stealing-over-50000-pension-benefits-meant-deceased-sister-law