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United HealthCare – Compensation and Benefit Costs for the Empire Plan for the Period January 1, 2008 through December 31, 2010
… Department of Civil Service (Civil Service) is responsible for administering the New York State Health Insurance Program … (United) to process and pay medical and surgical claims for services provided to Empire Plan members. During the … 31, 2010, the State paid United more than $50 million for direct costs related to employee compensation and …
https://www.osc.ny.gov/state-agencies/audits/2013/04/10/united-healthcare-compensation-and-benefit-costs-empire-plan-period-january-1-2008-throughMedicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
… Purpose To determine whether the Department of Health established adequate controls to prevent duplicate … services using the APG payment methodology. The Department of Health (Department) adopted the APG methodology in an … are reimbursed based on patient condition and complexity of service. The Department phased in the APG methodology …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-ambulatory-patient-groups-payments-duplicate-claims-and-services-excessAudit of the Tuition Assistance Program at New York Career Institute
… Education's Rules and Regulations when certifying students for State-funded Tuition Assistance Program (TAP) awards. … assistance to help eligible students pay tuition. For the three academic years ended June 30, 2011, NYCI … awards totaling $2.2 million that were paid to the school for 840 students. We reviewed a sample of 50 randomly …
https://www.osc.ny.gov/state-agencies/audits/2014/02/07/audit-tuition-assistance-program-new-york-career-instituteNew York Psychiatric Center – Controls Over State Resources (Follow-Up)
… included in our initial audit report, New York State Psychiatric Institute - Controls Over State Resources … (Report 2008-S-145). Background The New York State Psychiatric Institute (Institute), established in 1895, is …
https://www.osc.ny.gov/state-agencies/audits/2014/03/21/new-york-psychiatric-center-controls-over-state-resources-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… report, Overpayments for Services Also Covered by Medicare Part B (2010-S-50). Background Many of the State's Medicaid recipients are also eligible for Medicare Part B, which provides supplementary medical insurance … health care providers' Medicaid claims for Medicare Part B deductibles and coinsurance. The audit covered the …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… drug is an outpatient drug (other than a vaccine) that is usually administered by a health care …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsMedicaid Program – Improper Medicaid Payments for Recipients Diagnosed With Severe Malnutrition
… to a hospital will increase. Medicaid will only pay for medical care and services that are medically necessary, whose necessity is evident from … assessments and Medicaid billing rules; and Properly document severe malnutrition in a patient’s medical record. …
https://www.osc.ny.gov/state-agencies/audits/2019/04/08/medicaid-program-improper-medicaid-payments-recipients-diagnosed-severe-malnutritionEmpire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network
… Empire paid about $180.5 million for 158,305 special item claims during the audit period. Key Findings We found Empire did not pay for special item claims according to the terms of its contract with LIHN. … Empire overpaid LIHN hospitals $3,597,688 for 722 special item claims (83 percent of the claims sampled). As of July …
https://www.osc.ny.gov/state-agencies/audits/2019/11/29/empire-bluecross-improper-payments-special-items-billed-hospitals-within-long-island-healthFund Financial Data – 2023 Financial Condition Report
… fund balance is the amount of funds available at the end of the fiscal year. The operating result is the amount … Fund Balance (GAAP Basis) Increases From Prior Year At the end of State Fiscal Year (SFY) 2022-23, the General Fund …
https://www.osc.ny.gov/reports/finance/2023-fcr/fund-financial-dataWyandanch Union Free School District - Budget Review (B19-7-1)
… Variances were largely due to overestimated State aid ($1.6 million or 4 percent), outside services ($2.4 … Variances will be largely due to overestimated State aid ($733,166 or 2 percent), outside services ($1.1 million … and/or tax levy limit calculation. Be mindful of the legal requirement to maintain the tax levy increase to no …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/29/wyandanch-union-free-school-district-budget-review-b19-7-1Jericho Fire District – Professional Services (2012M-236)
… million. Key Findings The District’s procurement policy does not require the use of competitive methods when …
https://www.osc.ny.gov/local-government/audits/fire-district/2013/02/01/jericho-fire-district-professional-services-2012m-236Franklin County – Fiscal Stress (2013M-252)
… reserves to finance operations. The County’s enterprise infirmary fund was not self-sufficient, and therefore …
https://www.osc.ny.gov/local-government/audits/county/2013/10/04/franklin-county-fiscal-stress-2013m-252Rockland County – Budget Review (B6-13-22)
… revenue and expenditure projections in the County’s proposed budget for the 2014 fiscal year are reasonable. … of the Laws of 2013 requires the County to submit their proposed budget for the next fiscal year to the State … revenue and expenditure projections in the County’s proposed budget are reasonable. The proposed budget does not …
https://www.osc.ny.gov/local-government/audits/county/2013/11/25/rockland-county-budget-review-b6-13-22DiNapoli Audit: Drivers for Disabled New Yorkers Drove with Suspended Licenses; Racked up Hundreds of Violations, Including Speeding Through School Zones
… licenses, according to an audit released today by New York State Comptroller Thomas P. DiNapoli. "Much more needs to be … reimbursing OPWDD for fines incurred while driving State vehicles. To read the full report, including the agency's response, go to: https://www.osc.state.ny.us/audits/allaudits/093019/sga-2018-17s50.pdf Find …
https://www.osc.ny.gov/press/releases/2018/10/dinapoli-audit-drivers-disabled-new-yorkers-drove-suspended-licenses-racked-hundreds-violationsComptroller DiNapoli and Attorney General Underwood Announce Sentencing of Queens Pharmacy Owner for Stealing More than $1.5 Million from Medicaid
… the scheme, Value did not purchase sufficient amounts of medication from licensed New York state drug wholesalers that …
https://www.osc.ny.gov/press/releases/2018/07/comptroller-dinapoli-and-attorney-general-underwood-announce-sentencing-queens-pharmacy-ownerDiNapoli: Former Assemblyman William Scarborough Sentenced On Fraud and Theft Convictions
… Former New York State Assemblyman William Scarborough, 69, of Queens, New York, was sentenced today to 13 months in prison and two years of supervised release after being convicted of wire fraud and theft from a program receiving federal … Former New York State Assemblyman William Scarborough 69 of Queens New York was sentenced today to 13 months in prison …
https://www.osc.ny.gov/press/releases/2015/09/dinapoli-former-assemblyman-william-scarborough-sentenced-fraud-and-theft-convictionsOpinion 2000-9
… or her services, including salary or wages and authorized fringe benefits (see, e.g. 1988 Opns St Comp No. 88-64, p …
https://www.osc.ny.gov/legal-opinions/opinion-2000-9DiNapoli & Schneiderman Announce Sentencing of Former MET Council Insurance Broker
… to 2013, he conspired with co-defendants William Rapfogel, David Cohen and others to steal from Met Council through an … conspiracy began in 1992, when Ross devised a scheme with David Cohen, the executive director of Met Council, in which …
https://www.osc.ny.gov/press/releases/2015/03/dinapoli-schneiderman-announce-sentencing-former-met-council-insurance-brokerFormer Treasurer of Patterson Volunteer Fire Department Pleads Guilty To Fraud and Tax Charges Arising From His Embezzlement of More Than $1.1 Million
… Preet Bharara, the United States Attorney for the Southern District of New York, Shantelle P. Kitchen, … funds. Melin took money that was supposed to be used for fighting fires and other department needs, and instead … their books and expose these thefts. I thank U.S. Attorney for the Southern District Preet Bharara, the New York State …
https://www.osc.ny.gov/press/releases/2016/11/former-treasurer-patterson-volunteer-fire-department-pleads-guilty-fraud-and-tax-charges-arising-hisXII.8.B Matching – XII. Expenditures
… order is the Procurement Card. An agency must address match exceptions before a voucher processor can submit a voucher into workflow. An agency can view match exceptions associated with a particular voucher via a link on the voucher or in the match exceptions workbench. The match exceptions report …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii8b-matching