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Elwood Union Free School District - Claims Auditing (2019M-31)

… - pdf] Audit Objective Determine whether systems were in place to ensure that claims were adequately documented, were … result of this audit. … Determine whether systems were in place to ensure that claims were adequately documented were …

https://www.osc.ny.gov/local-government/audits/school-district/2019/04/05/elwood-union-free-school-district-claims-auditing-2019m-31

Comptroller DiNapoli Releases State Audits

… mission. Among the questionable expenses were payments for meetings, memberships in professional organizations, and … authority policy or lacked sufficient justification of the business need. NFTA lacked formal policies and procedures for … the costs for special events, memberships and gifts to business officials in another country. Rochester-Genesee …

https://www.osc.ny.gov/press/releases/2014/10/comptroller-dinapoli-releases-state-audits

Opinion 88-19

Whether the town can accept a gift of money from the citizens group to help defray legal expenses

https://www.osc.ny.gov/legal-opinions/opinion-88-19

As Racial Homeownership Disparities Persist, State's Mortgage Agency Increases Lending to Minority and Low-Income Borrowers

… communities, increasing its share of loans provided to low-income and minority borrowers over the last 10 years. … rates and 39 points higher than Latino rates, according to a report by State Comptroller Thomas P. DiNapoli. … released on a routine basis would give better insight into how programs can better help New Yorkers. DiNapoli’s report …

https://www.osc.ny.gov/press/releases/2025/06/racial-homeownership-disparities-persist-states-mortgage-agency-increases-lending-minority-and-low

General Brown Central School District - Building Renovation Project (2019M-21)

Did the Board and District officials properly establish, monitor and account for the building renovation project?

https://www.osc.ny.gov/files/local-government/audits/pdf/general-brown-21.pdf

State Comptroller DiNapoli Releases Audits

… with EmblemHealth Plan, Inc. (Emblem) to process and pay claims for services on behalf of the New York State …

https://www.osc.ny.gov/press/releases/2024/02/state-comptroller-dinapoli-releases-audits

Roxbury Central School District - Health Insurance Buyouts (2019M-89)

Determine whether District payments for health insurance buyouts were cost-effective, supported by collective bargaining agreements and correctly calculated.

https://www.osc.ny.gov/files/local-government/audits/pdf/roxbury-2019-89.pdf

UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers

… Purpose To determine whether UnitedHealthcare overpaid for … Surgery Centers that were contractually required to use in-network anesthesia providers. The audit covered the …

https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatory

United HealthCare – Empire Plan Drug Rebate Revenue

… The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The Department … required to negotiate agreements with drug manufacturers for rebates, discounts, and other considerations and pass 100 … of the agreements on to the prescription drug program. For the audit period, January 1, 2010 through December 31, …

https://www.osc.ny.gov/state-agencies/audits/2016/11/01/united-healthcare-empire-plan-drug-rebate-revenue

United Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)

… audit report, United HealthCare Insurance Company of New York: Empire Plan Drug Rebate Revenue ( 2013-S-41 ). Background The New York State Health Insurance Program (NYSHIP) provides health …

https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-follow

Empire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)

… Purpose To determine the extent of implementation of the three recommendations made in our audit report, New … benefits plan for NYSHIP. The New York State Department of Civil Service contracts with Empire BlueCross BlueShield …

https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-through

Empire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Follow-Up)

… extent of implementation of the three recommendations made in our audit report, New York State Health Insurance Program: … processes and pays Plan claims for hospital services in accordance with agreements Empire negotiates with member … Key Finding Empire officials made considerable progress in implementing the recommendations we made in our initial …

https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-through

New York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)

… of implementation of the four recommendations included in our initial audit report, New York State Health Insurance … NYBEAS disenrollment is entered after the date the change in eligibility takes effect, it is considered a retroactive … 2015 through December 2020. We identified $3.21 million in overpayments for services, which resulted primarily from …

https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-and

Comptroller DiNapoli Releases Municipal Audits

… P. DiNapoli today announced his office completed an audit of the Town of Cohocton , a budget review for the City of … DiNapoli. “By auditing municipal finances and operations, my office continues to provide taxpayers the assurance that … examined how municipalities complied with state laws when conveying parkland to a non-public entity or using …

https://www.osc.ny.gov/press/releases/2015/05/comptroller-dinapoli-releases-municipal-audits-1

Comptroller DiNapoli Releases Municipal Audits

… of Brookville , Village of Canajoharie , Fairport Public Library , Ravena-Coeymans-Selkirk Community Library , Rockland County and Town of Saugerties . “In …

https://www.osc.ny.gov/press/releases/2015/06/comptroller-dinapoli-releases-municipal-audits

An Analysis of Reasonable and Customary Out-of-Network Reimbursement Rates for Medical/Surgical Services in the New York State Health Insurance Program

… The Empire Plan is the primary health benefits plan for NYSHIP, covering 1.1 million of the NYSHIP members. The … (out-of-network) providers. United bases payment for most services provided by out-of-network providers either … rate. The R&C rate is generally based on provider charges for the same or similar service in the same or similar …

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

Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)

… Program (NYSHIP), administered by the Department of Civil Service (Civil Service), is one of the nation’s largest public sector …

https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-under

Anthem Blue Cross – Coordination of Benefits With Medicare

… Objective To determine whether Anthem Blue Cross coordinated benefits to properly pay claims for … from January 2020 through June 2023. About the Program The New York State Health Insurance Program (NYSHIP), … and their dependents have other insurance coverage in addition to the Empire Plan such as Medicare, the federal …

https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicare