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Medicaid Program - Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits (2013-S-17)
To determine whether the Department of Health established adequate controls to prevent duplicate and excessive Medicaid payments to clinics and outpatient facilities reimbursed by the Ambulatory Patient Groups (APG) payment methodology.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s17.pdfMedicaid Program - Payments for Death-Related One-Day Inpatient Admissions (2012-S-5), 90-Day Response
To determine whether the Department of Health (Department) appropriately and effectively implemented and applied the new APR DRG-based hospital inpatient paymen
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2012-12s5-response.pdfPrograms for Little Learners - Compliance With the Reimbursable Cost Manual (2017-S-87)
To determine whether the costs reported by Programs For Little Learners on its Consolidated Fiscal Reports were properly calculated, adequately documented...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2018-17s87.pdfMedicaid Program – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… Purpose To determine whether Davis Ethical Pharmacy (Davis Ethical) inappropriately billed Medicaid for … Program provides prescription drug coverage for enrollees. Davis Ethical is an independently owned pharmacy located in … To determine whether Davis Ethical Pharmacy Davis Ethical inappropriately billed …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/medicaid-program-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyMedicaid 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.pdfUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs (Follow-Up)
… included in our initial audit report, UnitedHealthcare Insurance Company of New York – Overpayments for … coverage. Civil Service contracts with UnitedHealthcare Insurance Company of New York (United) to administer the … included in our initial audit report UnitedHealthcare Insurance Company of New York Overpayments for …
https://www.osc.ny.gov/state-agencies/audits/2025/05/21/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsOverpayments for Therapy Services and Prescription Drugs Covered by Medicare (Follow-Up)
… (Report 2016-S-73 ). About the Program The New York State Medicaid program provides a wide range of medical … and/or have special health care needs. Many of the State’s Medicaid recipients are also enrolled in Medicare. … 2017 for therapy services. The audit concluded that the State’s Medicaid program paid $20.1 million for services …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/overpayments-therapy-services-and-prescription-drugs-covered-medicare-followOpioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program (Follow-Up)
… substance prescription drug use, known as the Internet System for Tracking Over-Prescribing (I-STOP), which contains …
https://www.osc.ny.gov/state-agencies/audits/2020/05/07/opioid-prescriptions-medicaid-recipients-opioid-treatment-program-followOpinion 88-28
… or statutory amendments that bear on the issues discussed in the opinion. OFFICIAL NEWSPAPER -- Designation of (criteria for designation in towns) LOCAL LAWS -- Official newspaper (designation by … §64(11): A publication must be a "newspaper" as defined in General Construction Law, §60 and must satisfy the …
https://www.osc.ny.gov/legal-opinions/opinion-88-28Retirement Online Security Administrator Authorization Form for State Employers (RS5547)
This form is for State employers to authorize a Security Administrator for Retirement Online, who will be responsible for submitting their location’s security authorization requests and monitoring individuals’ security access.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5547.pdfRetirement Online Security Administrator Authorization Form for Local Employers (RS5546)
This form is for local employers to authorize a Security Administrator for Retirement Online, who will be responsible for submitting their location’s security authorization requests and monitoring individuals’ security access.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5546.pdfMedicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… Objective To determine whether the Department of Health (DOH) provided adequate oversight to ensure managed care recipients in the Recipient Restriction Program received … (Restriction Program) was created to reduce the cost of inappropriate utilization by identifying Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs (2021-S-32) 180-Day Response
To determine whether UnitedHealthcare Insurance Company of New York appropriately reimbursed physician-administered drugs.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-21s32-response.pdfDiNapoli: Former Treasurer Pleads Guilty to Felony in Theft of More Than $5,000 in Fire District Funds
… treasurer for Pulteney Fire District No. 2 pleaded guilty today to stealing more than $5,000 in public funds, after an … salary. Lisa Stone, 45, of Hammondsport, pleaded guilty today to grand larceny in the third degree (a class D felony) … treasurer for Pulteney Fire District No 2 pleaded guilty today to stealing more than $5000 in public funds after an …
https://www.osc.ny.gov/press/releases/2015/05/dinapoli-former-treasurer-pleads-guilty-felony-theft-more-5000-fire-district-fundsDiNapoli: Former Treasurer of Frewsburg Central School District Pleads Guilty to Stealing Nearly $7,000 in School Funds
… and District Attorney Jason Schmidt today announced the arrest and guilty plea of Angela Smoulder, former Treasurer … to the district in the amount of $6,982.42. The arrest is a result of a joint investigation between the State … and District Attorney Jason Schmidt today announced the arrest and guilty plea of Angela Smoulder former Treasurer of …
https://www.osc.ny.gov/press/releases/2022/01/dinapoli-former-treasurer-frewsburg-central-school-district-pleads-guilty-stealing-nearly-7000-schoolInternal Controls for Billed Receivables and User Charges Webinar Presentation
Please join us as we discuss internal control framework for billed receivables and user charges, and go through the elements of a control environment to help ensure these activities are appropriate and safeguarded.
https://www.osc.ny.gov/files/local-government/academy/pdf/internal-controls-for-billed-receivables-and-user-charges-08-18-2021.pdfSelected Aspects of Accommodations for Passengers with Disabilities (Follow-Up) (2022-F-24)
To determine the extent of implementation of the seven recommendations included in our initial audit report, Selected Aspects of Accommodations for Passengers with Disabilities (2019-S-41).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22f24x.pdfFiscal Stress in School Districts: Common Themes for School Year 2018-19
This report summarizes results of school district scores for the 2018-19 fiscal school year (SY) and compares results to SYs 2016-17 and 2017-18. The report ref
https://www.osc.ny.gov/files/local-government/fiscal-monitoring/pdf/common-themes-for-school-year-2018-19.pdfImproper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (Follow-Up)
To determine the extent of implementation of the five recommendations included in our audit report Medicaid Program Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims Report 2022S16
https://www.osc.ny.gov/state-agencies/audits/2025/03/12/improper-medicaid-payments-outpatient-services-billed-inpatient-claims-followMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… for review. Medicaid reimbursement rates for inpatient hospital claims include the costs of most medical care provided during a hospital admission. As such, claims for ancillary services provided during a hospital admission are generally not reimbursable. In 2007, …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatient