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Medicaid 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.pdfMedicaid Program - Medicaid Payments for Pharmacy Claims – Joia Pharmacy and a Related Prescriber (2013-S-4), 90-Day Response
To determine whether Medicaid made proper payments to Joia Pharmacy, Inc. (Joia) and a related prescriber (herein referred to as “the Doctor”) in compliance wit
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2017-13s4-response.pdfUnited HealthCare: Overpayments for Services Provided by Hudson Valley Bone and Joint Surgeons, LLP (2016-S-17)
To determine whether Hudson Valley Bone and Joint Surgeons, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2016-16s17.pdfMedicaid Program - Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition (2017-S-85) 90-Day Response
To determine whether Medicaid made overpayments to hospitals that improperly billed All Patient Refined Diagnosis Related Groups inpatient claims ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s85-response.pdfNorthside Center for Child Development - Compliance With the Reimbursable Cost Manual (2017-S-15) 90-Day Response
To determine whether the costs reported by Northside Center for Child Development on its Consolidated Fiscal Report were reasonable, necessary...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2019-17s15-response.pdfReview of the Proposed Financial Plan and Capital Program for the Metropolitan Transportation Authority - October 2004
The MTA is the custodian of a regional mass transportation system that is critical to the economies of New York City and New York State.
https://www.osc.ny.gov/files/reports/osdc/pdf/report-7-2005.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.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 – Improper Payments for Sexual and Erectile Dysfunction Drugs, Procedures, and Supplies Provided to Medicaid Recipients, Including Sex Offenders
… Federal and State laws prohibit Medicaid payment of drugs for the treatment of sexual or erectile dysfunction (herein referred to as ED) for all Medicaid recipients, including registered sex offenders. In addition, Medicaid must not pay for ED drugs, unless that drug has another Food and Drug …
https://www.osc.ny.gov/state-agencies/audits/2019/06/03/medicaid-program-improper-payments-sexual-and-erectile-dysfunction-drugs-procedures-andState Comptroller DiNapoli & U.S. Attorney Announce Guilty Plea & Sentencing of Former Albany Resident for Defrauding NYS Retirement System of $130,624
… States Code, § 2113(b), and was sentenced to probation for three years, including one year of home confinement. … other schemes has ended in his guilty plea and an order for restitution to the pension fund of $130,624," State … now resides in Lugoff, S.C. collected retirement benefits for his sister, a former New York state employee, even though …
https://www.osc.ny.gov/press/releases/2017/12/state-comptroller-dinapoli-us-attorney-announce-guilty-plea-sentencing-former-albany-residentImproper Payments for Services Related to Ordering, Prescribing, Referring, or Attending Providers No Longer Participating in the Medicaid Program (Follow-Up)
… included in our initial audit report, Improper Payments for Services Related to Ordering, Prescribing, Referring, or … professionals providing services through the Medicaid fee-for-service program to be enrolled as participating providers … to determine whether the Department made improper payments for claims in violation of federal and State requirements …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/improper-payments-services-related-ordering-prescribing-referring-or-attending-providers-noDiNapoli and Oneida DA McNamara Announce Arrests of Utica School Superintendent and Former Utica Mayor for Theft of Public Funds
… Comptroller Thomas P. DiNapoli, Oneida County District Attorney Scott McNamara, and the New York State Police today … serve themselves. Thanks to my partnership with District Attorney McNamara and the State Police they will now be held accountable for their crimes.” District Attorney McNamara said: “I echo State Comptroller DiNapoli’s …
https://www.osc.ny.gov/press/releases/2023/11/dinapoli-and-oneida-da-mcnamara-announce-arrests-utica-school-superintendent-and-former-utica-mayorProgram Oversight and Monitoring of the Maximus Contract for the New York State of Health (Insurance Marketplace) Customer Service Center
… as the New York State of Health, to help New Yorkers shop for and enroll in health insurance coverage. Since 2010, the … to develop and operate a statewide enrollment center for the State’s public health insurance programs. Through … requiring Maximus to provide a complete sample population for each business function the Department reviews; and to …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/program-oversight-and-monitoring-maximus-contract-new-york-state-health-insuranceDiNapoli & A.G. Schneiderman Announce Arrest of Upstate Woman for Theft of over $67K in NYS Pension Benefits, $19K Welfare Fraud
… D felony, and one count of Offering a False Instrument for Filing in the First Degree, a class E felony. Banack is … on her application and re-certifications of eligibility for Medicaid assistance. "When her mother died, Tammy Banack … DiNapoli. "I thank Attorney General Schneiderman for partnering with us to find and prosecute those who steal …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-ag-schneiderman-announce-arrest-upstate-woman-theft-over-67k-nys-pension-benefits-19kAn 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-servicesDiNapoli: Tennessee Woman Pleads Guilty to Wire Fraud for Receiving Deceased Mother's New York State and Local Retirement System Benefits
… Thomas P. DiNapoli joined the United States Attorney for Eastern District of Tennessee (EDTN) in announcing that … USC. § 1343) in the U.S. District Court at Knoxville, TN for stealing $56,352 from the New York State and Local … informed NYSLRS that no death certificate had been issued for Conklin’s death, just a police report. After Conklin’s …
https://www.osc.ny.gov/press/releases/2022/03/dinapoli-tennessee-woman-pleads-guilty-wire-fraud-receiving-deceased-mothers-new-york-state-and-localDiNapoli, Erie County DA Keane and Erie County Sheriff Garcia Announce Former Deputy Clerk Sentenced for Stealing More Than $320,000
… Former Deputy Erie County Clerk Alexander McDougall was sentenced …
https://www.osc.ny.gov/press/releases/2025/01/dinapoli-erie-county-da-keane-and-erie-county-sheriff-garcia-announce-former-deputy-clerk-sentencedDiNapoli: Former Essex County Fair Treasurer and Willsboro Town Clerk Ordered To Pay Full Restitution for Theft of Nearly $90,000
… in the third degree as a crime of public corruption for stealing funds from the society and the town. “Bridget … County District Attorney Crawford and Superintendent James for their partnership in ensuring Bridget Brown was held accountable for her crimes.” “I am thankful to the investigators who …
https://www.osc.ny.gov/press/releases/2025/07/dinapoli-former-essex-county-fair-treasurer-and-willsboro-town-clerk-ordered-pay-full-restitutionState Agencies Bulletin No. P-833
Amend Procedure to Process Workers' Comp Supp Program for PS&T Emp NU 05
https://www.osc.ny.gov/files/state-agencies/payroll-bulletins/pdf/agencies-p-833.pdf