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An Analysis of Reasonable and Customary Out-of-Network Reimbursement Rates for Medical/Surgical Services in the New York State Health Insurance Program
… service in the same or similar geographic region. United’s reimbursement rates for out-of-network services are generally … — often significantly higher — than United’s in-network reimbursement rates. Consequently, services provided by … for 226,128,077 services. To illustrate, the average reimbursement for a routine office visit in 2016 was $29 for …
https://www.osc.ny.gov/state-agencies/audits/2020/04/01/analysis-reasonable-and-customary-out-network-reimbursement-rates-medicalsurgical-servicesDiNapoli: Tennessee Woman Pleads Guilty to Wire Fraud for Receiving Deceased Mother's New York State and Local Retirement System Benefits
… New York State Comptroller Thomas P. DiNapoli joined the United States Attorney for Eastern District of Tennessee … and Local Retirement System,” DiNapoli said. “I thank the United States Attorney for the Eastern District of Tennessee … to NYSLRS. Sentencing is set for July 14, 2022, in United States District Court for the EDTN at Knoxville. Since …
https://www.osc.ny.gov/press/releases/2022/03/dinapoli-tennessee-woman-pleads-guilty-wire-fraud-receiving-deceased-mothers-new-york-state-and-localDiNapoli: Greenburgh-Graham Union Free School District Superintendent and Former Security System Specialist Arrested on Corruption Charges for Stealing School Funds
… Levy and Surendra Kumar were entrusted with money meant to enrich the lives of students with disabilities; instead, … of the Trials and Investigations Division. The charges against the defendants are merely accusations, and the … public corruption and encourages the public to help fight fraud and abuse. New Yorkers can report allegations of …
https://www.osc.ny.gov/press/releases/2024/05/dinapoli-greenburgh-graham-union-free-school-district-superintendent-and-former-security-systemComptroller DiNapoli and Attorney General Underwood Announce Sentencing of Queens Pharmacy Owner for Stealing More than $1.5 Million from Medicaid
… NEW YORK – Attorney General Barbara D. Underwood and State … himself at the expense of vulnerable New Yorkers who rely on our Medicaid program. He now faces jail time and millions … a class C felony, and to violating the Social Services Law prohibition on the payment of kickbacks related to the …
https://www.osc.ny.gov/press/releases/2018/07/comptroller-dinapoli-and-attorney-general-underwood-announce-sentencing-queens-pharmacy-ownerDiNapoli, Erie County DA Keane and Erie County Sheriff Garcia Announce Former Deputy Clerk Sentenced for Stealing More Than $320,000
… was sentenced today to 1 1/3 to 4 years in state prison and ordered to pay full restitution after pleading guilty to … DiNapoli, Erie County District Attorney Michael J. Keane, and Erie County Sheriff John C. Garcia announced. “Today’s … in government to line their own pockets will be caught and punished,” DiNapoli said. “Alexander McDougall abused his …
https://www.osc.ny.gov/press/releases/2025/01/dinapoli-erie-county-da-keane-and-erie-county-sheriff-garcia-announce-former-deputy-clerk-sentencedArts, Entertainment and Recreation in New York City: Recent Trends and Impact of COVID-19
… arts events throughout the state. As part of the Revival, NY PopsUp, a series of free ‘pop-up’ events, will be held …
https://www.osc.ny.gov/reports/osdc/arts-entertainment-and-recreation-new-york-city-recent-trends-and-impact-covid-19Delaware County – Court and Trust (2022-C&T-2)
The purpose of our audit was to determine whether County officials established appropriate controls to safeguard and account for court and trust funds for the period January 1, 2019 through March 24, 2022.
https://www.osc.ny.gov/files/local-government/audits/2022/pdf/delaware-county-2022-ct-2.pdfOswego County – Court and Trust (2022-C&T-5)
The purpose of our audit was to determine whether County officials have established appropriate controls to safeguard and account for court and trust funds for the period January 1, 2019 through September 7, 2022.
https://www.osc.ny.gov/files/local-government/audits/2022/pdf/oswego-county-ct-2022-5.pdfJefferson County – Court and Trust (2022-C&T-6)
The purpose of our audit was to determine whether County officials have established appropriate controls to safeguard and account for court and trust funds for the period January 1, 2019 through September 7, 2022.
https://www.osc.ny.gov/files/local-government/audits/2022/pdf/jefferson-county-2022-ct-6.pdfThe Importance of Responsible Debt Management: Poor State Bond Structuring Choices Lead to Greater Costs for Taxpayers
In the throes of the economic uncertainty and fiscal turbulence caused by the COVID crisis, legislation was enacted as part of the SFY 2021-22 budget authorizing the use of State-supported bonding with final maturities up to 50 years for capital purposes for the MTA.
https://www.osc.ny.gov/files/reports/pdf/importance-of-responsible-debt-management.pdfImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up) (2022-F-31) 30-Day Response
To assess the extent of implementation of the nine recommendations included in our initial audit report, Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Report 2018-S-71).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22f31-response.pdfRecovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance (2021-S-24)
To determine whether Medicaid overpayments for inpatient services on behalf of managed care recipients who had third-party health insurance were appropriately recovered.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-21s24.pdfRecovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance (2020-S-39)
To determine whether Medicaid overpayments for pharmacy services on behalf of managed care recipients who had third-party health insurance were appropriately recovered.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-20s39.pdfEye Care Provider and Family Inappropriately Enroll as Recipients and Overcharge for Vision Services (Follow-Up) (2017-F-11)
To determine the implementation status of the eight recommendations in our initial audit report, Eye Care Provider and Family Inappropriately Enroll as Recipients and Overcharge for Vision Services (Report 2013-S-1) ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2017-17f11.pdfMedicaid Program - Improper Medicaid Payments Involving Fee-for-Service Claims for Recipients With Multiple Client Identification Numbers (2019-S-22)
To determine if improper Medicaid payments were made on behalf of recipients with multiple Client Identification Numbers (CINs) ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s22.pdfAdministration of the Contract With the Postgraduate Center for Mental Health (Follow-Up) (2019-F-51) 30-Day Response
To determine the extent of implementation of the nine recommendations included in our initial audit report, Administration of the Contract with With the Postgraduate Center for Mental Health (2015-S-88).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19f51-response.pdfEmpire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network (2017-S-43)
To determine whether Empire BlueCross paid claims for special items according to the terms of its contract with Long Island Health Network and, if not...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s43.pdfRetirement Option Election Form with Partial Lump Sum Payment For Tier 1 Members Designating Multiple Beneficiaries (RS6420-A)
For NYSLRS Tier 1 members to elect a pension payment option at retirement with a partial lump sum payment and to designate multiple beneficiaries.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6420-a.pdfMedicaid Program: Overpayments for Therapy Services and Prescription Drugs Covered by Medicare (2016-S-73) 90-Day Response
To determine if the Department of Health overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered by...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-16s73-response.pdfMedicaid Program: Reducing Medicaid Costs for Recipients With End Stage Renal Disease (Follow-Up) (2018-F-8) 30-Day Response
To determine the implementation status of the five recommendations made in our initial audit report, Reducing Medicaid Costs for Recipients With End Stage...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18f8-response.pdf