Search
Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
… for Pharmacy Services Covered by Managed Care (Report 2014-S-5 ). Background Our initial audit report, which was … Payments for Pharmacy Services Covered by Managed Care (2014-S-5) …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-fee-service-payments-pharmacy-services-covered-managed-care-followImproper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
… Substances That Exceed Allowed Dispensing Limits (Report 2013-S-59). Background The State’s Medicaid program provides … that, for the period January 1, 2009 through December 31, 2013, Medicaid overpaid pharmacies $1,183,601 for 13,705 … Substances That Exceed Allowed Dispensing Limits (2013-S-59) …
https://www.osc.ny.gov/state-agencies/audits/2016/09/23/improper-payments-controlled-substances-exceed-allowed-dispensing-limits-followDiNapoli: Despite Labor Force Gains, Disparities Remain for Workers With Disabilities
… A new report by State Comptroller Thomas P. DiNapoli shows the labor force … and 2024, while it dropped 0.5 percentage points for the state’s nondisabled workforce. Despite this progress, only … labor market that encouraged more inclusive hiring. State Policy Efforts New York State has taken several steps …
https://www.osc.ny.gov/press/releases/2025/11/dinapoli-despite-labor-force-gains-disparities-remain-workers-disabilitiesUnited HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
… December 31, 2014. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage … covering a range of services from inpatient hospital care to outpatient surgical procedures and physician office … Members pay a nominal co-payment to the participating provider for the services rendered. Members may also choose …
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
… costs reported on the Consolidated Fiscal Reports (CFRs) of the Whitestone School for Child Development (Whitestone) … education program to disabled children between the ages of three and five years. Whitestone, located in Queens, New … Whitestone officials to help ensure their proper reporting of reimbursable costs. To Whitestone: Ensure that costs …
https://www.osc.ny.gov/state-agencies/audits/2015/04/07/whitestone-school-child-development-compliance-reimbursable-cost-manualDiNapoli: Timely Remediation Essential for Success of State's Brownfield Cleanup Program
… New York State Department of Environmental Conservation’s (DEC) management of the program and found it must be … administration of the program from January 2019 to January 2025. Remediation Delays While many sites have been … running projects have been in the program between 17 and 20 years. Four were found to pose a ‘significant threat to …
https://www.osc.ny.gov/press/releases/2025/06/dinapoli-timely-remediation-essential-success-states-brownfield-cleanup-programUnitedHealthcare 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 … 2021-S-32 ). About the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to about 1.2 million active and retired …
https://www.osc.ny.gov/state-agencies/audits/2025/05/21/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsImproper Fee-for-Service Pharmacy Payments for Recipients With Third-Party Health Insurance (Follow-Up)
… where a TPHI carrier may have been liable for the cost of services provided to a Medicaid recipient. The Office of the Medicaid Inspector General (OMIG) contracted with Gainwell …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/improper-fee-service-pharmacy-payments-recipients-third-party-health-insurance-followDiNapoli Releases 2024 Fiscal Stress Scores for Villages and Some Cities
… year ending in 2024. DiNapoli’s office evaluated all non-calendar year local governments that filed their … are based on self-reported data, also cover 17 cities with non-calendar fiscal years, including the “Big 4” cities of … the AFR and the concerning increase in the number of non-filers. The webpage includes a tool to check the filing …
https://www.osc.ny.gov/press/releases/2025/04/dinapoli-releases-2024-fiscal-stress-scores-villages-and-some-citiesDiNapoli: State Tax Collections Outperform Projections for State Fiscal Year 2024-25
… Tax collections for State Fiscal Year (SFY) 2024-25 totaled $117.5 billion, … York State Comptroller Thomas P. DiNapoli. Tax collections for SFY 2024-25 were $11.1 billion (10.4%) higher than the … in 2024, the state’s tax collections outpaced forecasts for the year,” DiNapoli said. “However, policy decisions at …
https://www.osc.ny.gov/press/releases/2025/04/dinapoli-state-tax-collections-outperform-projections-state-fiscal-year-2024-25DiNapoli: Audit Recommends Improvements in Services for Survivors of Human Trafficking
The New York State Office of Temporary and Disability Assistance OTDA can take steps to improve its efforts to ensure survivors of human trafficking receive the services and assistance available to them according to an audit released today
https://www.osc.ny.gov/press/releases/2025/03/dinapoli-audit-recommends-improvements-services-survivors-human-traffickingChildren’s Center for Early Learning – Compliance With the Reimbursable Cost Manual
… allowable costs are included on any of their CFRs prepared after our scope period. Direct Center officials to disclose … “less-than-arm’s-length” transactions on any CFRs prepared after the scope period and prior to ceasing operations. To … Center: Ensure that costs reported on any CFRs prepared after the scope period comply with Manual requirements. Other …
https://www.osc.ny.gov/state-agencies/audits/2014/12/29/childrens-center-early-learning-compliance-reimbursable-cost-manualMilestone School for Child Development – Compliance With the Reimbursable Cost Manual
… make the appropriate adjustments to Milestone’s CFRs and reimbursement rates. Work with Milestone officials to help …
https://www.osc.ny.gov/state-agencies/audits/2015/07/17/milestone-school-child-development-compliance-reimbursable-cost-manualUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… improperly paid for medical services designated with modifier code 59 that were not distinct and independent from other … Civil Service administers the NYSHIP program and contracts with UnitedHealthcare (United) to process and pay medical and … improperly paid for medical services designated with modifier code 59 that were not distinct and independent …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59United HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… To determine whether Long Island Laparoscopic Surgery, PLLC waived Empire Plan members’ out-of-pocket costs, and if … submitted to United by Long Island Laparoscopic Surgery, PLLC (Long Island Laparoscopic), a non-participating provider … To determine whether Long Island Laparoscopic Surgery PLLC waived Empire Plan members outof pocket costs and if so …
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)
… other states’ efforts to limit Medicaid payments in areas where Medicaid and Medicare programs overlap. The remaining … 20 percent limitation on coinsurance charges in all cases where it was applicable; providers did not properly report … overpayments we identified and recover overpayments where appropriate. Furthermore, we recommended the Department …
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)
… initial audit report, Monitoring of Medicaid Payments for Nursing Home Bed Reserve Days (Report 2010-S-21). Background … which was issued on December 9, 2010, examined whether nursing home claims submitted to Medicaid for hospital bed … reserve days were appropriate, and if not, to what extent nursing home claims exceeded the bed reserve day limits. …
https://www.osc.ny.gov/state-agencies/audits/2013/01/10/monitoring-medicaid-payments-nursing-home-bed-reserve-days-followAdministration of Contract C007373 With the Institute for Community Living
… and single-occupancy apartments in Brooklyn, the Bronx, Manhattan, and Queens. ICL is authorized to service a maximum …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/administration-contract-c007373-institute-community-livingAstor Services for Children & Families – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Astor Services for Children & Families (Astor) on its Consolidated Fiscal … fiscal year ended June 30, 2013. Background Astor, a not-for-profit organization located in Rhinebeck, New York, … the ages of three and five years. Astor is reimbursed for preschool special education services through rates set by …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-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 Encounter Intake System. We conducted an early assessment of the readiness of Medicaid MCOs as of September 30, 2015. We …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-system