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DiNapoli Audit Finds Hundreds of Millions of Dollars in Medicaid Payments Went to Providers Not Enrolled in the Program
An audit released today by New York State Comptroller Thomas P DiNapoli found Medicaid managed care organizations made as much as $15 billion in improper and questionable payments to providers who did not appear to be enrolled in Medicaid
https://www.osc.ny.gov/press/releases/2024/06/dinapoli-audit-finds-hundreds-millions-dollars-medicaid-payments-went-providers-not-enrolled-programComptroller DiNapoli & A.G. Schneiderman Announce Sentencing of Defendant For Stealing Over $148k in NYS Pension Benefits
… was arrested on a warrant by the city of Tamarac Road Patrol and Broward County Sherriff’s in Florida. After being … and Comptroller DiNapoli thank the city of Tamarac Road Patrol and Broward County Sheriff’s in Florida for their …
https://www.osc.ny.gov/press/releases/2016/12/comptroller-dinapoli-ag-schneiderman-announce-sentencing-defendant-stealing-over-148k-nys-pensionDelaware County Industrial Development Agency – Project Monitoring and Website Transparency (2025M-88)
… assistance, including tax exemptions (e.g., real property, mortgage recording and sales and use taxes), to businesses to … various types of economic and community development. In return for financial assistance, project owners who receive … over job performance, sales and use tax exemptions, mortgage recording tax exemptions and capital investments. …
https://www.osc.ny.gov/local-government/audits/county/2025/12/19/delaware-county-industrial-development-agency-project-monitoring-and-websiteDiNapoli: Audit Recommends Improved Oversight of Nurse Licensing by State Education Department
… The State Education Department (SED) should improve its … misconduct, according to an audit released today by New York State Comptroller Thomas P. DiNapoli. The investigations of "priority 1" complaints against nurses … The State Education Department SED should improve its process …
https://www.osc.ny.gov/press/releases/2017/09/dinapoli-audit-recommends-improved-oversight-nurse-licensing-state-education-departmentReporting Services Provided by Lawyers and Law Firms (Education Law Section 2053)
… the law requires certain information to be filed with the Office of the Attorney General, the Office of the State Comptroller and the State Education … The system is available through the NYSED Business Portal. Each school district BOCES has a Delegated …
https://www.osc.ny.gov/retirement/employers/reporting-services-provided-lawyers-and-law-firms-education-law-section-2053DiNapoli: East Ramapo School Budget Hampered By Deficits, Inadequate Rainy Day Funds
… recommendations made in previous audits in August 2011 and July 2013 . Auditors discovered most of these recommendations … many major budget problems remain. Moving forward, careful short- and long-term budget planning is needed for the …
https://www.osc.ny.gov/press/releases/2016/06/dinapoli-east-ramapo-school-budget-hampered-deficits-inadequate-rainy-day-fundsLocal Sales Tax Collections Increased by 3% in July Compared to Last Year
… state grew by 3% in July compared to the same month in 2022, according to an analysis released today by State Comptroller Thomas P. DiNapoli. Overall, local … especially important.” For July 2023 compared with July 2022: New York City’s collections totaled $777 million, an …
https://www.osc.ny.gov/press/releases/2023/08/local-sales-tax-collections-increased-3-july-compared-last-yearUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… our audit report, UnitedHealthcare: Improper Payments for Medical Services Designated By Modifier Code 59 (Report … with UnitedHealthcare (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s payments to medical providers are based, in part, on procedure codes …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… the rates participating providers agree to accept for the same services. Consequently, to encourage members to use less … Overpayments for Services at the Capital Region Ambulatory Surgery Center (2007-S-72) New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… Purpose To determine whether Eastern Orange Ambulatory Surgery Center, LLC waived Empire Plan members’ out-of-pocket … on claims submitted to United by Eastern Orange Ambulatory Surgery Center, LLC (Eastern Orange), a non-participating … Overpayments for Services at the Capital Region Ambulatory Surgery Center (2007-S-72) New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial … 2011, Medicaid made improper payments totaling $94,460 to Davis Ethical Pharmacy. Based on information obtained from … indicated on the claims), auditors determined that Davis Ethical likely fabricated nearly all of the improper …
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
… for pharmacy services covered by recipients’ managed care plans. The audit covered the period October 1, 2011 … are economically disadvantaged and/or have special health care needs. In general, the Medicaid program pays medical … through either the fee-for-service method or the managed care plan method. Under the feefor- service method, Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up)
… Covered by Managed Long-Term Care Plans (Report 2018-S-65 ). About the Program The State’s Medicaid program offers …
https://www.osc.ny.gov/state-agencies/audits/2021/08/31/improper-fee-service-payments-services-covered-managed-long-term-care-plans-followMedicaid Program – Improper Fee-for-Service Payments for Services Covered by Long-Term Care Plans
… payments for certain services covered by managed long-term care (MLTC) plans. The audit covered the period January 1, … are enrolled in MLTC plans. MLTC plans provide long-term care services, such as home health care, nursing home care, and durable medical equipment, to …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/medicaid-program-improper-fee-service-payments-services-covered-long-term-care-plansMedicaid Program – Accuracy of Medicaid Eligibility Determined by NY State of Health
… properly sent accurate, complete, and timely Medicaid eligibility and enrollment information to the Medicaid claims … and other health insurance plans. An individual’s Medicaid eligibility and enrollment information is transmitted from … system relies on the information sent by NYSOH to update eligibility and enrollment data necessary to make appropriate …
https://www.osc.ny.gov/state-agencies/audits/2020/09/17/medicaid-program-accuracy-medicaid-eligibility-determined-ny-state-healthImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… covered by Medicare. The audit covered the period January 1, 2015 through July 31, 2019. We determined the Department …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followMedicaid Program – Overpayments for Therapy Services and Prescription Drugs Covered by Medicare
… Objective To determine if the Department of Health overpaid health care providers’ Medicaid claims for therapy services and prescription drugs that are covered by Medicare. The audit covered the period January 1, 2012 to December 31, 2016 for prescription drugs and January 1, …
https://www.osc.ny.gov/state-agencies/audits/2019/10/30/medicaid-program-overpayments-therapy-services-and-prescription-drugs-covered-medicareState Agencies Bulletin No. 1410
… Purpose To inform agencies of new earnings codes and procedures for processing the third … within the purview of the Agreement between the State of New York and the United University Professions. Effective … begin date and pay period end date for each pay type. New Earnings Codes OSC has created new earnings codes to …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1410-third-phase-deficit-reduction-plan-psnu-employees-summer-seasonalState Agencies Bulletin No. 1329
… earnings codes and procedures for processing the second phase of the Summer Seasonal Lifeguard Deficit Reduction … University Professions. Effective Date(s) The second phase of the Summer Seasonal Lifeguard Deficit Reduction Plan … summer season. Monies collected as part of the second phase will be repaid to the employee. Attachment A provides a …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1329-second-phase-deficit-reduction-plan-psnu-employees-summer-seasonalOpinion 88-41
Whether the town may purchase instructional equipment to be used by a private nonprofit organization in presenting fire prevention programs to town residents
https://www.osc.ny.gov/legal-opinions/opinion-88-41