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Medicaid Program - Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (2013-S-57)
To determine if Medicaid overpaid managed care organizations and hospitals for low birth weight newborn claims.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s57.pdfMedicaid 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
… Utica Mayor and UCSD School Board President Louis LaPolla for allegedly using taxpayer funds to pay for political campaigns and a non-school related fundraiser. … and the State Police they will now be held accountable for their crimes.” District Attorney McNamara said: “I echo …
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
… Anthony Banack selected to receive his pension as a Pop Up Joint Allowance Half, which provided him with a reduced … set at $20,000 bond or cash. If convicted, Banack faces up to 5 to 15 years in state prison. The charges are …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-ag-schneiderman-announce-arrest-upstate-woman-theft-over-67k-nys-pension-benefits-19kDiNapoli: 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: Greenburgh-Graham Union Free School District Superintendent and Former Security System Specialist Arrested on Corruption Charges for Stealing School Funds
… Free School District were arrested on corruption charges for allegedly stealing school district funds earmarked for students and spending them on personal and luxury … their own lives by spending the money on lavish gifts for themselves,” DiNapoli said. “Thanks to my partnership …
https://www.osc.ny.gov/press/releases/2024/05/dinapoli-greenburgh-graham-union-free-school-district-superintendent-and-former-security-systemDiNapoli, Erie County DA Keane and Erie County Sheriff Garcia Announce Former Deputy Clerk Sentenced for Stealing More Than $320,000
… authority and diverted funds meant to benefit taxpayers for his own use. I thank Erie County District Attorney … John Garcia, and Erie County Comptroller Kevin R. Hardwick for their partnership in bringing him to justice.” In August, … counts of grand larceny and offering a false instrument for filing. McDougall, 55, today appeared in Erie County …
https://www.osc.ny.gov/press/releases/2025/01/dinapoli-erie-county-da-keane-and-erie-county-sheriff-garcia-announce-former-deputy-clerk-sentencedComptroller DiNapoli and Attorney General Underwood Announce Sentencing of Queens Pharmacy Owner for Stealing More than $1.5 Million from Medicaid
… re-locating to its current location in Lynbrook, NY, for defrauding the New York State Medicaid program out of … to pay $1.5 million to New York State as restitution for the money stolen from Medicaid and an additional $1.5 million in financial penalties, for a total of $3 million. "Mr. Goldin sought to enrich …
https://www.osc.ny.gov/press/releases/2018/07/comptroller-dinapoli-and-attorney-general-underwood-announce-sentencing-queens-pharmacy-owner