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United HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… Ethical Pharmacy inappropriately billed United HealthCare for prescription medications under the State's employee … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP and includes prescription drug coverage. The … on the primary contract, the Department reimburses United for all properly adjudicated claims. Davis Ethical Pharmacy …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… of GHI and HIP Health Plan of New York, formed when the two companies affiliated in 2006. At that time, existing GHI … still needed. Of the three prior audit recommendations, two recommendations had been implemented and one recommendation was no longer applicable. Key …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followMedicaid Program – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… 1, 2008 through December 13, 2011. Background The New York State Medicaid Program provides prescription drug coverage … Nassau County District Attorney (NCDA) and the New York State Department of Financial Services (DFS). In December … other sanctions. Consider referring William Davis to the State Education Department for assessment of his professional …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/medicaid-program-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacySpecial Plan for Town of Elmira District #1 Traffic Officers (Sections 89-q and 603(m))
… Top) (Return to Top) VO1839 (Rev. 6/12) © 2012, New York State and Local Retirement System (Return to Top) … …
https://www.osc.ny.gov/retirement/publications/special-plan-town-elmira-district-1-traffic-officers-sections-89-q-and-603mUnited HealthCare – Overpayments for Services Provided by Long Island Bone and Joint, LLP
… provided to Empire Plan members. United contracts with in-network (participating) providers who agree to accept … submitted to United by Long Island Bone and Joint, LLP (LI Bone and Joint), a non-participating provider located at … period January 1, 2011 through October 31, 2015, United paid claims totaling $8 million for services provided by LI …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/united-healthcare-overpayments-services-provided-long-island-bone-and-joint-llpNew York Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… whether the costs reported by the New York Center for Child Development, Inc. (NYCCD) on its Consolidated … known as the Manhattan Center for Early Learning, Inc., is a New York Citybased not-for-profit organization authorized … its annual CFRs. SED reimburses DoE for a portion of its payments to NYCCD based on statutory rates. Reimbursable …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/new-york-center-child-development-inc-compliance-reimbursable-cost-manualDiNapoli: Potential Changes in Federal Policies Pose Risks for New York City's Budget
… Medicaid," DiNapoli said. "With these risks in mind, Mayor de Blasio and the city have prudently increased reserves to …
https://www.osc.ny.gov/press/releases/2017/08/dinapoli-potential-changes-federal-policies-pose-risks-new-york-citys-budgetOverpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
… Medicaid pays managed care organizations (MCOs) a fixed monthly capitation payment for each newborn enrolled in the … provision of covered health care services. In addition to monthly capitation payments, MCOs receive supplemental … were implemented. Other Related Audit/Report of Interest Department of Health: Overpayments to Managed Care …
https://www.osc.ny.gov/state-agencies/audits/2016/12/07/overpayments-managed-care-organizations-and-hospitals-low-birth-weight-newborns-followQuestionable Payments for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician (Follow-Up)
… Purpose To determine the implementation status of the four … for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician ( 2012-S-35 ). Background Our initial …
https://www.osc.ny.gov/state-agencies/audits/2017/09/19/questionable-payments-practitioner-services-and-pharmacy-claims-pertaining-selectedSpecial Plan for Suffolk County Probation Department Peace Officers (Sections 89-s and 603-o)
… and Local Retirement System (Return to Top) … Information for members about 25 year special plan providing alternative retirement benefit for Suffolk County peace officers …
https://www.osc.ny.gov/retirement/publications/special-plan-suffolk-county-probation-department-peace-officers-sections-89-s-and-603-oDiNapoli Seeks Stronger Federal Safety Measures for Oil Trains to Protect New Yorkers
… Thomas P. DiNapoli, in a letter released today, called on the U.S. Department of Transportation and the Federal Railroad Administration to strengthen safety … two major carriers of crude oil in New York state – CSX Corporation and Canadian Pacific Railway Limited – revealed …
https://www.osc.ny.gov/press/releases/2016/04/dinapoli-seeks-stronger-federal-safety-measures-oil-trains-protect-new-yorkersDiNapoli: Three Arrested for Scheme to Steal Unclaimed Funds from New York State
… charges arising out of their scheme to fraudulently obtain unclaimed funds held by the New York State Comptroller’s Office of …
https://www.osc.ny.gov/press/releases/2022/07/dinapoli-three-arrested-scheme-steal-unclaimed-funds-new-york-stateDiNapoli: Syracuse City School District Employees Pay Over $31,000 for Submitting False Timecards
… Attorney Carla B. Freedman and Terry Harris, Special Agent in Charge, U.S. Department of Education Office of Inspector … $31,872.90 to resolve allegations that they submitted false timecards in connection with the school district’s … lawsuit filed under the qui tam provision of the False Claims Act, which allows private persons, known as …
https://www.osc.ny.gov/press/releases/2022/05/dinapoli-syracuse-city-school-district-employees-pay-over-31000-submitting-false-timecardsNYS Comptroller DiNapoli Statement on Major Support for Racial Equity Audit at Amazon
… New York State Comptroller Thomas P. DiNapoli released the … and neither are Amazon's shareholders. We will continue to press Amazon to take an independent look at how it is …
https://www.osc.ny.gov/press/releases/2021/05/nys-comptroller-dinapoli-statement-major-support-racial-equity-audit-amazonMedicaid Program – Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare
… About the Program Hospice is a coordinated program of home and/or inpatient care that treats terminally ill … Hospice programs provide palliative care, including nursing, physician, and counseling services; home health … Care (MLTC) plans, which serve people who require nursing home or long-term home health care. When a Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/12/28/medicaid-program-improper-medicaid-payments-individuals-receiving-hospice-services-coveredImproper Managed Care Premium Payments for Recipients With Duplicate Client Identification Numbers (Follow-Up)
… The Department of Health (Department) administers the State’s Medicaid program. Each individual who applies for … information, including the assignment of CINs, from the NY State of Health and the downstate and upstate Welfare …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/improper-managed-care-premium-payments-recipients-duplicate-client-identification-numbersDiNapoli: Finger Lakes Group Homes Overpaid for Food and Supplies, Wasting Taxpayer Money
… The state’s Office for People with Developmental Disabilities’ Finger Lakes … Service Office (DDSO) skirted state procurement laws for more than 1,400 purchases worth more than $1 million, … advantage in obtaining the state’s business and overpaid for hundreds of household items, according to an audit …
https://www.osc.ny.gov/press/releases/2015/06/dinapoli-finger-lakes-group-homes-overpaid-food-and-supplies-wasting-taxpayer-moneyDiNapoli: NYC Tax Collections Expected to Fall for First Time Since Great Recession
… in 2020, according to a report released today by New York State Comptroller Thomas P. DiNapoli. Tax collections are … without additional federal assistance, another round of state budget cuts. With so many uncertainties, and a recovery … plan. The plan assumes that the gross city product will contract by 12.9 percent in 2020 (the largest decline since …
https://www.osc.ny.gov/press/releases/2020/05/dinapoli-nyc-tax-collections-expected-fall-first-time-great-recessionMount Sinai Fire District - Financial Condition and Price Quotations for Purchases (2019M-83)
… District’s financial condition. Determine if the District is seeking competition for purchases that are under the …
https://www.osc.ny.gov/local-government/audits/fire-district/2019/08/23/mount-sinai-fire-district-financial-condition-and-price-quotationsUniversity Preparatory Charter School for Young Men – Student Enrollment and Billing (2013M-292)
… of Audit The purpose of our audit was to examine the School’s student enrollment and billing process for the … 16, 2013. Background The University Preparatory Charter School for Young Men is located in the City of Rochester and is governed by a 10-member Board. The School’s …
https://www.osc.ny.gov/local-government/audits/charter-school/2014/01/24/university-preparatory-charter-school-young-men-student-enrollment-and