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Medicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… Purpose To determine whether the Department of Health (Department) made Medicaid mainstream managed care premium payments on behalf of individuals who had … As of August 2017, 4.4 million people were enrolled in mainstream managed care plans – about 2.5 million were …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… to medical providers are based, in part, on procedure codes billed on claims that indicate the medical services … assessment to identify providers with unusual modifier 59 billing patterns and take appropriate actions, including … new fraud and abuse detection program to identify aberrant billing patterns, including inappropriate uses of modifier …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followChanges in Federal Policies Pose Significant Risks for New York City's Budget
… Projected budget gaps for New York City in the coming years appear manageable, but tax …
https://www.osc.ny.gov/press/releases/2017/12/changes-federal-policies-pose-significant-risks-new-york-citys-budgetMedicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… well as the rules and policies set forth by the Department of Health (Department) and the State Education Department. … 2008 through December 31, 2012. Note : During the course of the audit, the audit fieldwork was temporarily suspended … with a review by other external oversight authorities of some of the matters addressed in this report. Subsequent …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/medicaid-program-medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriberPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Purpose To determine the extent of implementation of the three … 13, 2011, Medicaid made improper payments totaling $94,460 to Davis Ethical Pharmacy. Based on information obtained from … that patients actually picked-up the drugs billed to Medicaid. Moreover, as a result of our audit, we concluded …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… disadvantaged and/or have special health care needs. In general, the Medicaid program pays medical providers … a monthly premium for every Medicaid recipient enrolled in the MCO, and the MCO arranges for the provision of … was no longer appropriate for recipients enrolled in managed care. As of December 2013, approximately 4 million …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careDiNapoli Statement on Greenville Arrest for Alleged Theft of Taxpayer Funded Resources
… the following statement regarding the arrest of Terry Williams for alleged theft of fuel from the Town of … by DiNapoli’s office and the New York State Police. "Mr. Williams allegedly abused his position by taking, for his own … my ongoing partnership with the New York State Police, Mr. Williams' alleged acts have been brought to light and he will …
https://www.osc.ny.gov/press/releases/2018/07/dinapoli-statement-greenville-arrest-alleged-theft-taxpayer-funded-resourcesDiNapoli Announces Interim CIO for the New York State Common Retirement Fund
… retiring the week of July 30 after six years of service. "My thanks go to Vicki Fuller, during whose tenure the Fund … public employees, retirees and their beneficiaries." "My gratitude goes to Comptroller DiNapoli for his trust and …
https://www.osc.ny.gov/press/releases/2018/07/dinapoli-announces-interim-cio-new-york-state-common-retirement-fundSpecial Plan for Suffolk County Park Police Officers (Sections 89-r and 603(n))
… (Return to Top) (Return to Top) (Return to Top) (Return to Top) VO1855 (Rev. 6/12) © 2012, New York State and Local …
https://www.osc.ny.gov/retirement/publications/special-plan-suffolk-county-park-police-officers-sections-89-r-and-603nMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… Purpose To determine whether the Department of Health took sufficient steps to control the Medicaid costs of recipients diagnosed with end stage … who were eligible for, but not enrolled in, Medicare. The audit covered the period January 1, 2010 through December …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-diseaseOversight of Hotels and Motels Used for Homeless and Mixed-Use Temporary Residency
… (DOH) are adequately ensuring that hotels and motels used for homeless and mixed-use temporary residency are properly … portion of their homeless populations. In fact, for many rural counties, hotels and motels are the only … shelter facility. OTDA has assigned responsibility for the inspection of hotels and motels housing the homeless …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-hotels-and-motels-used-homeless-and-mixed-use-temporary-residencyLifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… the ages of three and five years. During the 2014-15 school year, Lifeline served about 52 students. The New York … space and staff with a DoE District 75 program that serves school-age special education students. Key Findings For the …
https://www.osc.ny.gov/state-agencies/audits/2017/10/12/lifeline-center-child-development-inc-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by Brookville Center for Children’s … directly related to the special education program, and sufficiently documented pursuant to the State Education … To SED: Review the recommended disallowances resulting from our audit and make the appropriate adjustments to …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualDiNapoli: Contractor Sentenced in Federal Court for Defrauding State of Over $360,000
… statewide to combat corruption in the misuse of public funds.” Junkovic, 49, of the Bronx, pleaded guilty in … Bilingual SEIT and Preschool Inc. DiNapoli encourages the public to help fight fraud and abuse. New Yorkers can report …
https://www.osc.ny.gov/press/releases/2014/09/dinapoli-contractor-sentenced-federal-court-defrauding-state-over-360000Special 25-Year Plan for Institutional Safety Officers (Sections 89-t and 604(q))
… (Return to Top) VO1873 (Rev. 7/11) © 2011, New York State and Local Retirement System (Return to Top) … Information for members about special 25 year retirement plan providing an alternative retirement benefit for institutional safety officers and safety and secur …
https://www.osc.ny.gov/retirement/publications/special-25-year-plan-institutional-safety-officers-sections-89-t-and-604qUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… LLC waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from … it will result in United making an excessive payment on the claim. Our audit focused on claims submitted to United …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… whether the Department of Health paid pharmacy providers for controlled substances in compliance with the New York … risk of drugs ordered in this manner being diverted for inappropriate or unauthorized use. The supply limits that … overpaid pharmacies $1,183,601 for 13,705 fee-for-service claims, in which quantities of controlled substances exceeded …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… and retired State, participating local government, and school district employees and their dependents. The Empire …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandDiNapoli Proposal Would Provide More Accountability for Personal Income Tax Check-Off Funds
… efficiently and effectively to address these challenges. My bill will help make sure these funds are being put to good …
https://www.osc.ny.gov/press/releases/2015/04/dinapoli-proposal-would-provide-more-accountability-personal-income-tax-check-fundsDiNapoli Announces Nominee for the Commission on Ethics and Lobbying in Government
… today announced his nomination of Nancy G. Groenwegen to the Commission on Ethics and Lobbying in Government. Groenwegen previously served as counsel to the Comptroller from 2010 to 2019. “Nancy is well known for her integrity and …
https://www.osc.ny.gov/press/releases/2022/07/dinapoli-announces-nominee-commission-ethics-and-lobbying-government