Search
Medicaid Program – Improper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements
… that require an appropriate National Provider Identifier (NPI) for ordering, prescribing, referring, and attending … for Medicaid claims that did not contain an appropriate NPI in the OPRA fields and resulted in: $1.5 billion in … that did not contain an appropriate referring or attending NPI (for example, some claims contained NPIs of providers who …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-claims-not-compliance-ordering-prescribingInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… made in our initial audit report, Inappropriate Premium Payments for Recipients No Longer Enrolled in … program. Managed care plans (Plans) receive monthly premium payments for individuals enrolled in their plans. The … Department of Health (Department) has the right to recover premium payments from Plans for inappropriately enrolled …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andExcessive Premium Payments for Dual-Eligible Recipients Enrolled in Mainstream Managed Care and Health and Recovery Plans (Follow-Up)
… and/or substance use disorders. Within MMC and HARP is the Integrated Benefits for Dually Eligible Enrollees …
https://www.osc.ny.gov/state-agencies/audits/2024/05/08/excessive-premium-payments-dual-eligible-recipients-enrolled-mainstream-managed-care-andMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… in addition to Medicaid (e.g., employer-based coverage or Medicare Part A). Medicaid is considered the payer of last …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsIFB #0001 – Disaster Recovery Services for the Printing, Sorting and Mailing of Payroll Checks and Tax Forms
… information as it becomes available, is available for download through the following links: Invitation for Bids , in PDF Forms Only , in MS Word format Cost Proposa l, in MS … in Adobe Acrobat PDF format and may be opened with the free Acrobat reader, available through this link: …
https://www.osc.ny.gov/procurement/ifb0001NYS Comptroller DiNapoli and Church of England Call on ExxonMobil to Set Targets for Lowering GHG Emissions
… along with investors' confidence." Edward Mason, Head of Responsible Investment for the Church Commissioners, said: … with the overarching expectations of the Climate Action 100+ initiative, of ensuring companies develop business … about the importance of releasing a more comprehensive disclosure report. A number of investors have joined the Fund …
https://www.osc.ny.gov/press/releases/2018/12/nys-comptroller-dinapoli-and-church-england-call-exxonmobil-set-targets-lowering-ghg-emissionsDiNapoli: 33.55 Percent Annual Investment Return for New York State Pension Fund Is Largest in Its History
… New York State Comptroller Thomas P. DiNapoli today announced that the New York State Common Retirement Fund’s (Fund) estimated overall … State Comptroller DiNapoli announced that the New York State Common Retirement Funds estimated overall investment …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-33-point-55-percent-annual-investment-return-new-york-state-pension-fund-largest-its-historyThe Critical Role of Nonprofits in New York
This report analyzes the most recent employment and wage data released by the U.S. Bureau of Labor Statistics for charitable organizations identified as 501(c)(3)s for the period 2017 through 2022.
https://www.osc.ny.gov/files/reports/pdf/critical-role-of-nonprofits-in-new-york.pdfReport on the State Fiscal Year 2021-22 Executive Budget
The COVID-19 pandemic has had a severe fiscal impact on New York State, and the Executive Budget for State Fiscal Year (SFY) 2021-22 demonstrates the need for additional federal assistance.
https://www.osc.ny.gov/files/reports/budget/pdf/executive-budget-report-2021-22.pdfUnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Follow-Up) (2023-F-14)
To determine the extent of implementation of the four recommendations included in our initial audit report, New York State Health Insurance Program – UnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Report 2020-S-7).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-23f14.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 Medicaid Payments for Outpatient Services Billed as Inpatient Claims (2022-S-16)(180-Day Response)
To determine whether Medicaid made improper payments to hospitals for outpatient services that were erroneously billed as inpatient claims.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22s16-response.pdfNew Yorkers in Need: A Look at Poverty Trends in New York State for the Last Decade
The COVID-19 pandemic had devastating health, economic and social consequences. In New York, the pandemic and ensuing economic shutdown produced almost 2 million job losses in 2020. Yet for many, economic hardships existed long before this time.
https://www.osc.ny.gov/files/reports/pdf/new-yorkers-in-need-poverty-trends.pdfImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up) (2021-F-4) 30-Day Response
To determine the extent of implementation of the three recommendations included in our initial audit report, Improper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Report 2018-S-65).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-21f4-response.pdfImproper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements (2019-S-2)
To determine whether the Department of Health paid for claims in violation of federal and State regulations that require an appropriate National Provider Identifier for ordering, prescribing, referring, and attending (OPRA) health care providers.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-19s2.pdfImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (2018-S-71) 180-day response
To determine whether Medicaid made improper payments to providers on behalf of dual-eligible individuals receiving hospice care covered by Medicare.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-18s71-response.pdfQuality Services for the Autism Community - Compliance With the Reimbursable Cost Manual (2018-S-8) 180-Day Response
To determine whether the costs reported by Quality Services for the Autism Community on its Consolidated Fiscal Report were reasonable, necessary ...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-18s8-response.pdfEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals (2019-S-31) 180-Day Response
To determine whether Empire BlueCross properly paid hospital claims for intraocular procedures. The audit covered the period January 1, 2014 through June 30...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s31-response.pdfAccounting and Financial Reporting for Pensions as Required by GASB 68 and Updated by GASB 82
The purpose of this bulletin is to provide updated information regarding pension accounting treatment and guidance.
https://www.osc.ny.gov/files/local-government/publications/pdf/gasb-68-reporting-for-pensions-0320.pdf