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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

… and customary (R&C) rate. MultiPlan, Inc. is the provider network leased by United to supplement its own network. If the out-of-network provider does not receive the MultiPlan rate, United will reimburse the provider at the R&C rate. The R&C rate is generally based on …

https://www.osc.ny.gov/state-agencies/audits/2020/04/01/analysis-reasonable-and-customary-out-network-reimbursement-rates-medicalsurgical-services

Program Oversight and Monitoring of the Maximus Contract for the New York State of Health (Insurance Marketplace) Customer Service Center

… Health, to help New Yorkers shop for and enroll in health insurance coverage. Since 2010, the Department has had a … and Bureau officials had already taken actions to address the matters we identified to help ensure Maximus’ … Oversight of the Early Intervention Program’s State Fiscal Agent (2015-S-22) …

https://www.osc.ny.gov/state-agencies/audits/2016/06/16/program-oversight-and-monitoring-maximus-contract-new-york-state-health-insurance

Improper Payments for Services Related to Ordering, Prescribing, Referring, or Attending Providers No Longer Participating in the Medicaid Program (Follow-Up)

… screened and enrolled in Medicaid and have an "active" provider status. Through the screening and provider enrollment process, the Department gains a level of … We determined Medicaid made $965 million in payments for 2.3 million OPRA services by physicians and professionals who …

https://www.osc.ny.gov/state-agencies/audits/2024/01/03/improper-payments-services-related-ordering-prescribing-referring-or-attending-providers-no

Medicaid Program – Improper Payments for Sexual and Erectile Dysfunction Drugs, Procedures, and Supplies Provided to Medicaid Recipients, Including Sex Offenders

… To determine whether Medicaid recipients, including sex offenders, inappropriately received Medicaid-funded … as ED) for all Medicaid recipients, including registered sex offenders. In addition, Medicaid must not pay for ED … of procedures and supplies to treat ED for registered sex offenders. Key Findings Medicaid made improper payments …

https://www.osc.ny.gov/state-agencies/audits/2019/06/03/medicaid-program-improper-payments-sexual-and-erectile-dysfunction-drugs-procedures-and

DiNapoli Commends Legislature for Passing Bill to Modernize Banking Development District Program and Expand Access to Capital in Underserved Communities

… to satisfy collateral requirements for state deposits. The change would free up additional capital for essential banking … communities, it can only do so as long as it remains easy to participate in," said Anderson . "The bill my …

https://www.osc.ny.gov/press/releases/2026/06/dinapoli-commends-legislature-passing-bill-modernize-banking-development-district-program-and-expand

New York City Restaurant, Retail and Recreation Sectors Still Face Uphill Recovery

This report examines the damage the pandemic has inflicted on the RRR sectors, and considers the distribution of federal funds for businesses in the City, particularly for businesses in low- and moderate-income communities and in historically underutilized business zones.

https://www.osc.ny.gov/files/reports/osdc/pdf/report-17-2022.pdf

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