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Medicaid Program - Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (2013-S-57)
To determine if Medicaid overpaid managed care organizations and hospitals for low birth weight newborn claims.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s57.pdfMedicaid Program - Excessive Medicaid Payments to Federally Qualified Health Centers for Group Therapy Services (2013-S-51)
To determine if Medicaid reimbursement rates for group therapy services provided by Federally Qualified Health Centers were correctly applied
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s51.pdfMedicaid Program - Questionable Payments for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician (2012-S-35)
To determine if Dr. Riaz Ahmad complied with Medicaid policies and whether Dr. Ahmad’s medical records support the services he billed and the prescriptions he
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-12s35.pdfChildren’s Center for Early Learning - Compliance With the Reimbursable Cost Manual (2011-S-21), 90-Day Response
To determine whether the expenses reported on the Consolidated Fiscal Reports (CFRs) of the Children’s Center for Early Learning (Center) were calculated proper
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-11s21-response.pdfYork College - Time and Attendance Practices for Public Safety Staff (Follow-Up) (2018-F-29) 30-Day Response
To determine the extent of implementation of the seven recommendations included in our initial audit report, Time and Attendance Practices for Public Safety...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18f29-response.pdfMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities (2014-S-18), 90-Day Response
To determine whether the Department established adequate controls over inpatient claims for recipients who were transferred between merged or consolidated
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2014-14s18-response.pdfOutdated Municipal Structures Cities, Towns and Villages – 18th Century Designations for 21st Century Communities
Outdated Municipal Structures Cities, Towns and Villages – 18th Century Designations for 21st Century Communities
https://www.osc.ny.gov/files/local-government/publications/pdf/munistructures.pdfMedicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (Follow-Up) (2018-F-26) 90-Day Response
To determine the extent of implementation of the four recommendations made in our initial audit report, Medicaid Payments for Pharmacy Claims – Joia Pharmacy...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-18f26-response.pdfAccounting for Medicaid Reimbursements Paid by the Department of Health and the Resulting State Aid Deduction
Accounting for Medicaid Reimbursements Paid by the Department of Health and the Resulting State Aid Deduction
https://www.osc.ny.gov/files/local-government/publications/pdf/MedicaidReimbursements0414.pdfMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement (2022-S-40) 180-Day Response
To determine whether Medicaid inappropriately paid for drugs from manufacturers that did not enter into a national drug rebate agreement (NDRA).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2024-22s40-response.pdfMedicaid Program: Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers (2023-S-18)
To determine whether the Department of Health (DOH) provided adequate oversight to ensure managed care recipients in the Recipient Restriction Program received services from the appropriate providers.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-23s18.pdfSpecial 20-Year Plan for Investigators in the Office of a District Attorney (Sections 89-d and 89-d(m))
Information for members about special 20 year retirement plan for Tier 1 and Tier 2 investigators assigned to the office of a district attorney
https://www.osc.ny.gov/retirement/publications/special-20-year-plan-investigators-office-district-attorney-sections-89-d-and-89-dmMedicaid Program – Improper Payments for Recipients No Longer Enrolled in Managed Long Term Care Partial Capitation Plans
… plans for recipients who were no longer enrolled in these plans. The audit covered the period January 1, 2010 … problem or disability. Generally, recipients enrolled in these Plans need home care, adult day health care, or … capitation payment for every Medicaid recipient enrolled in a Plan, and the Plan arranges for the provision of …
https://www.osc.ny.gov/state-agencies/audits/2016/03/30/medicaid-program-improper-payments-recipients-no-longer-enrolled-managed-long-term-careAssessment of Costs to Administer the Workers’ Compensation Program for the Fiscal Year Ended March 31, 2014
… and nonoccupational disabilities and sickness. Coverage for these benefits, with limited exception, is to be provided by their employers. The Board is also responsible for tracking its costs to administer the Workers’ … employee payroll expenses and are allocated appropriately for future assessments. Other Related Audits/Reports of …
https://www.osc.ny.gov/state-agencies/audits/2016/10/26/assessment-costs-administer-workers-compensation-program-fiscal-year-ended-march-31-2014Far Rockaway Pre-School Provider "Investor" Pleads Guilty in Theft of Education Funds Intended for Special Needs Students
… New York State Comptroller Thomas P. DiNapoli and Queens District Attorney Richard A. Brown today announced … was located at 1854 Cornaga Avenue in Far Rockaway, Queens, and primarily provided services to pre-school children in Far Rockaway in Queens and Williamsburg and Borough Park in Brooklyn. The …
https://www.osc.ny.gov/press/releases/2017/04/far-rockaway-pre-school-provider-investor-pleads-guilty-theft-education-funds-intended-special-needsMedicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
… adequate controls to prevent duplicate and excessive Medicaid payments to clinics and outpatient facilities … from December 1, 2008 through May 29, 2013. Background The Medicaid program reimburses outpatient services using the APG … surgery centers on September 1, 2009. Key Findings Medicaid made $32.1 million in actual and potential …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-ambulatory-patient-groups-payments-duplicate-claims-and-services-excessComptroller DiNapoli, Manhattan D.A. Bragg Announce Guilty Plea of Former NYU Director of Finance for Major Fraud
… and PCM Group Inc. (“PCM”). A portion of the funds were then used to pay legitimate grant-related expenses, and to …
https://www.osc.ny.gov/press/releases/2024/02/comptroller-dinapoli-manhattan-da-bragg-announce-guilty-plea-former-nyu-director-finance-major-fraudDiNapoli: Former Medical Office Manager Arrested for Scheme to Defraud the New York State Health Insurance Plan
… Her husband was a New York State employee, and the family was enrolled in NYSHIP. As a medical office manager, … providers. In those instances, the employee or family member receives any allowable reimbursement by check … innocent unless and until proven guilty in a court of law. Since taking office in 2007, DiNapoli has committed to …
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
… abusing his position for personal gain,” DiNapoli said. “I thank Attorney General James and the New York State Police … Today, we are ensuring that he will be held accountable. I thank Comptroller DiNapoli and our partners in law … the public to help fight fraud and abuse. New Yorkers can report allegations of fraud involving taxpayer money by …
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
… Purpose To determine if BlueCross BlueShield’s (Empire’s) payments to St. Mary’s Hospital (St. Mary’s) for … made according to the provisions of the agreement between Empire and St. Mary’s. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011