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DiNapoli: Pre-K Special Education Schools Took $1.4 Million in Unallowed Expenses
… not have required performance justification; $132,846 in salary to employees who worked for other programs operated by …
https://www.osc.ny.gov/press/releases/2016/11/dinapoli-pre-k-special-education-schools-took-14-million-unallowed-expensesOverpayments for Services Also Covered By Medicare Part B (Follow-Up) (2015-F-4)
We have followed up on the actions taken by officials of the Department of Health (Department) to implement the recommendations contained in our audit report, O
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-15f4.pdfDiNapoli: Former Medical Office Manager Arrested for Scheme to Defraud the New York State Health Insurance Plan
… in Manhattan, for her alleged role in a long-term scheme to defraud the New York State Insurance Plan (NYSHIP) out of … DiNapoli, Ulster County District Attorney Clegg, and the FBI Hudson Valley White Collar Crime Task Force. … investigation was initiated by a complaint from United Healthcare Special Investigations Unit, who assisted with the …
https://www.osc.ny.gov/press/releases/2023/09/dinapoli-former-medical-office-manager-arrested-scheme-defraud-new-york-state-health-insurance-planMedicare Part D – Federal Prescription Drug Benefits Program
This bulletin highlights the Medicare Part D Federal prescription drug benefits program and provides appropriate accounting guidance for Federal subsidies recei
https://www.osc.ny.gov/files/local-government/publications/pdf/medicared.pdfState Agencies Bulletin No. 919
… changes that are required to apply the proper taxation for employees who are receiving a retroactive military … Employees Employees receiving a retroactive pay increase for military stipend Effective Date(s) August 19, 2009 … and described how the FICA status would be updated for employees beginning or ending military stipend beginning …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/919-taxation-retroactive-raise-payments-employees-receiving-military-stipendWillsboro Central School District – Student State Aid (2023M-119)
… 2023, the District had not claimed $55,771 in State aid to which it was entitled, of which $52,640 would have already … a timely manner. The District also claimed $8,569 in aid to which it was not entitled. District officials also did not: Establish adequate procedures to ensure State aid was properly claimed for all special …
https://www.osc.ny.gov/local-government/audits/school-district/2024/02/02/willsboro-central-school-district-student-state-aid-2023m-119City of Amsterdam – Budget Review (B24-5-5)
The purpose of our budget review was to provide an independent evaluation of the Citys proposed budget for 202425
https://www.osc.ny.gov/local-government/audits/city/2024/05/13/city-amsterdam-budget-review-b24-5-5State Agencies Bulletin No. 1280
… fringe benefits such as the Certification, Licensure and Exam Fee Reimbursement are considered taxable income. … in the PEF or CSEA Certification, Licensure and Exam Fee Reimbursement Program Effective Date(s) Institution …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1280-certification-licensure-and-exam-fee-reimbursement-clefr-2013Improper Medicaid Payments to Hospitals for Outpatient Services Billed as Inpatient Services for Recipients Enrolled in Managed Care
… hospitals, MCOs reimburse the hospitals. The Centers for Medicare & Medicaid Services (CMS) defines outpatient care …
https://www.osc.ny.gov/state-agencies/audits/2024/08/28/improper-medicaid-payments-hospitals-outpatient-services-billed-inpatient-servicesMedicaid Program – Improper Medicaid Payments During Permissible Overlapping Medicaid and Essential Plan Coverage
… periods of overlapping insurance coverage. Medicaid is the payer of last resort, which means recipients’ other third-party health insurance coverage, such as insurance under the Essential Plan, must be exhausted … as secondary payer, should pay any remaining liabilities, such as deductibles and coinsurance. Key Findings Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-improper-medicaid-payments-during-permissible-overlapping-medicaid-andEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… Purpose To determine the extent of implementation of the three … Program (NYSHIP) provides health insurance coverage to active and retired State, participating local government …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughMedicaid Program – Claims Processing Activity October 1, 2021 Through March 31, 2022
… Objective To determine whether the Department of Health’s (Department’s) eMedNY system reasonably ensured that … who also had concurrent comprehensive third-party health insurance; $8.9 million was paid for clinic, …
https://www.osc.ny.gov/state-agencies/audits/2022/12/13/medicaid-program-claims-processing-activity-october-1-2021-through-march-31-2022Medicaid Program – Claims Processing Activity October 1, 2022 Through March 31, 2023
… of Health’s eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers, were … The audit covered the period October 2022 through March 2023, and certain claims going back to June 2022. About the …
https://www.osc.ny.gov/state-agencies/audits/2023/10/25/medicaid-program-claims-processing-activity-october-1-2022-through-march-31-2023DiNapoli: New York State Gets 91 Cents for Every Dollar Sent to Washington
… For every dollar New York sends to Washington D.C., it receives about 91 cents back in federal spending – compared to a national average of nearly $1.22, according to a report released today by State Comptroller Thomas P. …
https://www.osc.ny.gov/press/releases/2015/10/dinapoli-new-york-state-gets-91-cents-every-dollar-sent-washingtonBenchmark Family Services, Inc. – Compliance With the Reimbursable Cost Manual
… as needed. Other Related Audits/Reports of Interest Rochester Childfirst Network: Compliance With the …
https://www.osc.ny.gov/state-agencies/audits/2016/12/29/benchmark-family-services-inc-compliance-reimbursable-cost-manualRochester Childfirst Network – Compliance With the Reimbursable Cost Manual
To determine whether the costs reported by Rochester Childfirst Network on its Consolidated Fiscal Report CFR were properly calculated adequately documented
https://www.osc.ny.gov/state-agencies/audits/2016/11/17/rochester-childfirst-network-compliance-reimbursable-cost-manualTown of Babylon – Financial Condition and Internal Controls Over Selected Town Operations (2013M-115)
… 2011 through July 31, 2012. Background The Town of Babylon is located in western Suffolk County. The Town is governed by the Town Board, which comprises five elected …
https://www.osc.ny.gov/local-government/audits/town/2013/11/22/town-babylon-financial-condition-and-internal-controls-over-selected-town-operationsReimbursement of Homeless Shelter Providers – Westhab Inc.’s Coachman Family Center (Follow-Up)
… to OTDA for homeless housing was $2 billion or more for calendar years 2019 through 2022. Since 1996, the Westchester … for 100 adult families, serves over 250 families per year. Westhab is the single largest provider of these … Local Districts’ claim submissions must comply with OTDA’s Fiscal Reference Manual, which provides guidance on costs …
https://www.osc.ny.gov/state-agencies/audits/2024/08/08/reimbursement-homeless-shelter-providers-westhab-incs-coachman-family-center-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… (DME) as a benefit of the program. DME includes devices or equipment, such as wheelchairs or oxygen equipment, that can withstand repeated use and have … on a monthly rental basis, subject to certain limits (or caps). A special category of DME – oxygen equipment – is …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsDiNapoli: Middletown Chiropractor Sentenced to Nine Years for Insurance Fraud
… pay $9.7 million in restitution and forfeit $9.1 million. "Mr. Spina orchestrated a massive criminal health insurance … of dollars,” DiNapoli said. “This type of fraud harms all New Yorkers and contributes to higher health care costs … Inspector General and the Orange County Sheriff's Office, Mr. Spina has been held accountable." U.S. Attorney Audrey …
https://www.osc.ny.gov/press/releases/2021/04/dinapoli-middletown-chiropractor-sentenced-nine-years-insurance-fraud