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United HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… 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-long-island-laparoscopic-surgeryExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … more proactive culture that seeks to ensure that Medicaid is the payer of last resort for services provided to dual …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followMonitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Follow-Up)
… our initial audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). … examined whether nursing home claims submitted to Medicaid for hospital bed reserve days were appropriate, and if not, … 31, 2010, our audit determined Medicaid paid $28 million for bed reserve claims that exceeded the bed reserve day …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followUnited HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
… Spine Specialists, P.C. waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made … primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital care to outpatient … HealthCare - Overpayments for Services at the South Shore Ambulatory Surgery Center (2008-S-11) … To …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-spine-specialistsWhitestone School for Child Development – Compliance With the Reimbursable Cost Manual
… Fiscal Reports (CFRs) of the Whitestone School for Child Development (Whitestone) were calculated properly, … Manual (Manual). The audit included all expenses claimed for the fiscal year 2012-13 and certain expenses for the two fiscal years ended June 30, 2012. Background …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualMedicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… Purpose To determine the readiness of all Medicaid managed care organizations (MCOs) to submit Medicaid encounter transactions to the new …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemWestchester School for Special Children – Compliance With the Reimbursable Cost Manual
… whether the costs reported by the Westchester School for Special Children (WSSC) on its Consolidated Fiscal … SED. SED reimburses DoE and the other school districts for a portion of its payments to WSSC. For the four years ended June 30, 2011, WSSC claimed …
https://www.osc.ny.gov/state-agencies/audits/2013/07/02/westchester-school-special-children-compliance-reimbursable-cost-manualMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… different hospitals, two separate payments are made: a payment for the first hospital’s claim and a payment for the second hospital’s claim. However, according … between merged or consolidated facilities only one payment should have been made – to the first hospital. The …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilitiesAdministration of the Contract With the Center for Urban Community Services
… Purpose We audited the New York City Department of Health and Mental Hygiene’s (DOHMH) administration of a contract … 2015. The audit included a review of costs claimed by CUCS and paid by DOHMH for the year ended June 30, 2013. Our … on unsupported average annual salaries and related fringe benefits instead of actual employee compensation costs …
https://www.osc.ny.gov/state-agencies/audits/2016/02/16/administration-contract-center-urban-community-servicesChildren’s Center for Early Learning – Compliance With the Reimbursable Cost Manual
… Fiscal Reports (CFRs) of the Children’s Center for Early Learning (Center) were calculated properly, … education providers, such as the Center, are reimbursed for their services using tuition rates established by SED … the financial information reported on their annual CFRs. For the three fiscal years ended June 30, 2009, the Center …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/childrens-center-early-learning-compliance-reimbursable-cost-manualMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement
… To determine whether Medicaid inappropriately paid for drugs from manufacturers that did not enter into a … the Department of Health and Human Services in exchange for state Medicaid coverage of most of the manufacturer’s … Manufacturers then pay states rebates on those drugs for which Medicaid payments were made. Covered outpatient …
https://www.osc.ny.gov/state-agencies/audits/2024/02/23/medicaid-program-improper-payments-drugs-without-federal-drug-rebate-agreementAid and Incentives for Municipalities (AIM) and Temporary Municipal Assistance (TMA)
… AIM In each State fiscal year, the Aid and Incentives for Municipalities (AIM) program provides state aid to all of New York’s cities (other than New York City), towns and villages. …
https://www.osc.ny.gov/local-government/data/aid-and-incentives-municipalities-aim-and-temporary-municipal-assistance-tmaDiNapoli Urges Parents to Open a College Savings Account for Their Children
… College Saving Program has helped New York residents pay for more than $230 million in college-related expenses in … Education Services Corp., is designed to help parents save for college and offers tax deductions up to $10,000 annually. … is to plan ahead. It’s never too early to begin saving for your child’s future," DiNapoli said. "I encourage parents …
https://www.osc.ny.gov/press/releases/2014/05/dinapoli-urges-parents-open-college-savings-account-their-childrenUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs (Follow-Up)
… of implementation of the eight recommendations included in our initial audit report, UnitedHealthcare Insurance … a vaccine) that is administered by a health care provider in a physician’s office or other outpatient clinical setting. … through December 2021. We identified over $5.5 million in actual and potential overpayments for …
https://www.osc.ny.gov/state-agencies/audits/2025/05/21/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsDiNapoli: Timely Remediation Essential for Success of State's Brownfield Cleanup Program
… health and safety at risk and cost the state more money,” DiNapoli said. “The New York State Department of …
https://www.osc.ny.gov/press/releases/2025/06/dinapoli-timely-remediation-essential-success-states-brownfield-cleanup-programImproper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (Follow-Up)
… audit report, Medicaid Program: Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (Report … program. The Medicaid program reimburses hospitals for inpatient and outpatient services. A recipient’s status … versus outpatient—affects Medicaid’s reimbursement for services provided. Inpatient care generally requires …
https://www.osc.ny.gov/state-agencies/audits/2025/03/12/improper-medicaid-payments-outpatient-services-billed-inpatient-claims-followDiNapoli: Audit Recommends Improvements in Services for Survivors of Human Trafficking
… The New York State Office of Temporary and Disability Assistance … take steps to improve its efforts to ensure survivors of human trafficking receive the services and assistance available to …
https://www.osc.ny.gov/press/releases/2025/03/dinapoli-audit-recommends-improvements-services-survivors-human-traffickingDiNapoli: State Tax Collections Outperform Projections for State Fiscal Year 2024-25
… Tax collections for State Fiscal Year (SFY) 2024-25 totaled … released by New York State Comptroller Thomas P. DiNapoli. Tax collections for SFY 2024-25 were $11.1 billion (10.4%) …
https://www.osc.ny.gov/press/releases/2025/04/dinapoli-state-tax-collections-outperform-projections-state-fiscal-year-2024-25DiNapoli Releases 2024 Fiscal Stress Scores for Villages and Some Cities
… Fiscal Stress Monitoring System (FSMS) for their fiscal year ending in 2024. DiNapoli’s office evaluated all non-calendar year local governments that filed their financial reports in … 2024 including 518 villages, most of which have a fiscal year ending on May 31. The scores, which are based on …
https://www.osc.ny.gov/press/releases/2025/04/dinapoli-releases-2024-fiscal-stress-scores-villages-and-some-citiesImproper Fee-for-Service Pharmacy Payments for Recipients With Third-Party Health Insurance (Follow-Up)
… the Program The Department of Health (DOH) administers New York’s Medicaid program. Under the fee-for-service (FFS) …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/improper-fee-service-pharmacy-payments-recipients-third-party-health-insurance-follow