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Medicaid 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 … care needs. In general, the Medicaid program pays medical providers through either the fee-for-service method or the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… from 2016 to 2018, which includes $17 million in savings for counties and New York City. "New Yorkers dealing with … expenses and may provide them with more options for care." DiNapoli said. "The state has an obligation not … health care needs. The program is administered by DOH. For the fiscal year ended March 31, 2016, New York's Medicaid …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-state-missing-out-millions-medicare-payments-kidney-patientsDiNapoli: Former Clerk Treasurer for the Village of Speculator Charged With Larceny
… Town Court on April 28, 2020. New Yorkers can report allegations of fraud involving taxpayer money by calling the …
https://www.osc.ny.gov/press/releases/2020/02/dinapoli-former-clerk-treasurer-village-speculator-charged-larcenyDiNapoli: NYC Projects $3 Billion Surplus for 2015, Balanced Budget Next Year
… New York City is projecting a surplus of $3 billion for … a balanced budget for FY 2016 with relatively small gaps in the following three years, according to a review of the … market. Since the end of 2009, the city has added 503,000 jobs, and employment now totals a record 4.2 million. The …
https://www.osc.ny.gov/press/releases/2015/06/dinapoli-nyc-projects-3-billion-surplus-2015-balanced-budget-next-yearState Comptroller DiNapoli Statement on Arrest of Muge Ma for COVID-Related Scam
… New York State Comptroller Thomas P. DiNapoli released a … for the government to obtain life-saving medical equipment in order to line his own pocket. Using a public health crisis …
https://www.osc.ny.gov/press/releases/2020/05/state-comptroller-dinapoli-statement-arrest-muge-ma-covid-related-scamHebrew Academy for Special Children, Inc. – Compliance With the Reimbursable Cost Manual
… determine whether the costs reported by the Hebrew Academy for Special Children, Inc. (Hebrew Academy) on its … primarily on expenses claimed on Hebrew Academy’s CFR for the fiscal year ended June 30, 2017 and included certain expenses claimed on its CFRs for the two fiscal years ended June 30, 2016. About the …
https://www.osc.ny.gov/state-agencies/audits/2020/02/04/hebrew-academy-special-children-inc-compliance-reimbursable-cost-manualImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up)
… of the three recommendations included in our initial audit report, Improper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Report 2018-S-65 ). About the Program The State’s Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2021/08/31/improper-fee-service-payments-services-covered-managed-long-term-care-plans-followQuality Services for the Autism Community – Compliance With the Reimbursable Cost Manual
… 2015, we identified $128,294 in reported costs that did not comply with the RCM’s requirements for reimbursement. The … was lacking, $4,419 for 4 employees because hours were not documented by attendance records, and $1,748 for 20 employees who are not qualified to work above 1.0 full-time equivalent (FTE) …
https://www.osc.ny.gov/state-agencies/audits/2019/12/31/quality-services-autism-community-compliance-reimbursable-cost-manualMedicaid Program – Improper Fee-for-Service Payments for Services Covered by Long-Term Care Plans
… 30, 2019. About the Program The Department administers New York’s Medicaid program. Many of the State’s Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/medicaid-program-improper-fee-service-payments-services-covered-long-term-care-plansGlobal Investor Coalition Calls on Exxon to Prepare for a Lower Carbon Future
… DiNapoli and the Church of England are urging ExxonMobil to disclose the resilience of its business model in the wake … in Exxon shares. “The unprecedented Paris agreement to rein in global warming may significantly affect Exxon’s operations,” said DiNapoli, who is Trustee of the New York State Common Retirement Fund. “As …
https://www.osc.ny.gov/press/releases/2016/01/global-investor-coalition-calls-exxon-prepare-lower-carbon-futureAdministration of the Contract With the Postgraduate Center for Mental Health (Follow-Up)
… of the Contract With the Postgraduate Center for Mental Health ( 2015-S-88 ). About the Program Our … Supportive Housing Contract with the Postgraduate Center for Mental Health (PCMH). The audit found sampled clients … negatively affect the health and/or safety of clients. For example, three apartments had significantly damaged …
https://www.osc.ny.gov/state-agencies/audits/2020/09/15/administration-contract-postgraduate-center-mental-health-followDiNapoli: Orange County Resident Arrested for Stealing Her Late Mother’s Pension Benefits
… Thomas P. DiNapoli, Orange County District Attorney David M. Hoovler, and the New York State Police today … protecting public funds,” Orange County District Attorney David Hoovler said. Betty James died on April 11, 2017, but …
https://www.osc.ny.gov/press/releases/2021/06/dinapoli-orange-county-resident-arrested-stealing-her-late-mothers-pension-benefitsDiNapoli: School District Tax Levy Cap Below 2 Percent for Second Straight Year
… to local governments and school districts in 2012, limits annual tax levy increases to the lesser of the rate of …
https://www.osc.ny.gov/press/releases/2021/01/dinapoli-school-district-tax-levy-cap-below-2-percent-second-straight-yearMedicaid Program – Overpayments for Therapy Services and Prescription Drugs Covered by Medicare
… claims for therapy services and prescription drugs that are covered by Medicare. The audit covered the period January … About the Program Many of the State’s Medicaid recipients are also enrolled in Medicare. Such individuals are referred to as “dual-eligibles.” The Medicare program …
https://www.osc.ny.gov/state-agencies/audits/2019/10/30/medicaid-program-overpayments-therapy-services-and-prescription-drugs-covered-medicareUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … process and pay medical claims from health care providers for services provided to Empire Plan members. United … pay a nominal co-payment to the participating provider for the services rendered. Members may also choose to receive …
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
… providers for controlled substances in compliance with the New York State Controlled Substances Act, which limits the … disadvantaged and/or have special health care needs. The New York State Controlled Substances Act (Act), which was …
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 if so, to quantify the overpayments made by United HealthCare resulting from this practice. The audit covered … providers. In accordance with the Empire Plan’s requirements, when United processes a non-participating provider’s claims, it is with the understanding that Empire Plan …
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
… within the year they were made and report how the money was spent to the public and state officials. “New … on their personal income tax forms, but too much of this money remains unused when it should be fighting cancer, … who donate to these causes have a right to expect their money is being used efficiently and effectively to address …
https://www.osc.ny.gov/press/releases/2015/04/dinapoli-proposal-would-provide-more-accountability-personal-income-tax-check-fundsMedicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… the Department paid Joia more than $7.7 million for 50,060 claims on behalf of 706 recipients. The Doctor was listed as the prescriber on 31,351 (63 percent) of the 50,060 claims. Key Findings Based on a statistical projection of our … Department overpaid Joia $1,485,121 for improper pharmacy claims. Disallowances included: Claims billed for excess …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/medicaid-program-medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriberDiNapoli Announces Improvements to College Savings Plan to Save Money for College
… Beginning in September, New York's 529 College Savings Program will offer more investment options, … cost of obtaining a college education continues to rise. NY's 529 College Savings Program can help offset some of …
https://www.osc.ny.gov/press/releases/2017/09/dinapoli-announces-improvements-college-savings-plan-save-money-college