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Medicaid Program – Claims Processing Activity October 1, 2020 Through March 31, 2021
… Objective To determine whether the Department of Health’s (Department) eMedNY system … were processed in accordance with Medicaid requirements, and resulted in correct payments to the providers. The audit covered the period from October 2020 … To determine whether the Department of Healths eMedNY system reasonably ensured …
https://www.osc.ny.gov/state-agencies/audits/2022/04/19/medicaid-program-claims-processing-activity-october-1-2020-through-march-31-2021Medicaid Program – Improper Supplemental Maternity Capitation Payments to Managed Care Organizations
… (MCOs) a monthly premium for each enrolled recipient and, in turn, the MCOs pay for services their members require. In addition to the monthly premiums, MCOs can receive a … not eligible to receive SMCPs for maternity cases that end in termination or a miscarriage, as these are considered …
https://www.osc.ny.gov/state-agencies/audits/2021/11/29/medicaid-program-improper-supplemental-maternity-capitation-payments-managed-careMedicaid Program – Oversight of Managed Long-Term Care Member Eligibility
… MLTC plans, which provide long-term care services, such as home health care and nursing home care, for people who are chronically ill or disabled. …
https://www.osc.ny.gov/state-agencies/audits/2022/08/05/medicaid-program-oversight-managed-long-term-care-member-eligibilityMedicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… Program The Department of Health (Department) administers New York’s Medicaid program. Many of the State’s Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsMedicaid Program – Claims Processing Activity April 1, 2020 Through September 30, 2020
… Objective To determine whether the Department of Health’s (Department) eMedNY system reasonably ensured … 151 million claims, resulting in payments to providers of more than $38 billion. The claims are processed and paid … for inpatient claims that were billed at a higher level of care than what was actually provided; $892,790 was paid …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-claims-processing-activity-april-1-2020-through-september-30-2020Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… Managed Care and Family Health Plus (Report 2015-S-47 ). About the Program Most Medicaid recipients are enrolled …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andMedicaid Program – Claims Processing Activity April 1, 2022 Through September 30, 2022
To determine whether the Department of Healths eMedNY system reasonably ensured that Medicaid claims were submitted by approved providers were processed in accordance with Medicaid requirements and resulted in correct payments to providers
https://www.osc.ny.gov/state-agencies/audits/2023/05/11/medicaid-program-claims-processing-activity-april-1-2022-through-september-30-2022Managed Care Payments to Unenrolled Providers (Follow-Up)
… the problems we identified in the initial audit report. For example, DOH improved monitoring of MCO compliance with …
https://www.osc.ny.gov/state-agencies/audits/2026/03/31/managed-care-payments-unenrolled-providers-followTown of Parish - Financial Condition and Supervisor's Records (2019M-58)
… complete report - pdf] Audit Objective Determine whether the Board adequately managed the Town’s financial condition and received accurate financial reports to help it do so. Key Findings The Board did not adopt structurally … Determine whether the Board adequately managed the Towns financial condition …
https://www.osc.ny.gov/local-government/audits/town/2019/05/29/town-parish-financial-condition-and-supervisors-records-2019m-58DiNapoli: NYC Metro Transportation Costs Rose 56% Over Past Decade, Slower Than Other Major Areas
… metropolitan areas according to a report released today by State Comptroller Thomas P. DiNapoli. Transportation made up … the clock to help keep some costs relatively low. City and state officials need to keep a close eye on transportation … metropolitan areas according to a report released today by State Comptroller Thomas P DiNapoli …
https://www.osc.ny.gov/press/releases/2024/09/draft-dinapoli-nyc-metro-transportation-costs-grew-slower-other-major-cities-still-rose-29-percentOpinion 91-2
… being conducted by the comptroller, and, in a proper case, to bring with him, a book or paper". We believe this …
https://www.osc.ny.gov/legal-opinions/opinion-91-2DiNapoli Seeks Information on Safety Measures Taken by Businesses Involved in Shipping Oil
… billion New York State Common Retirement Fund (Fund), on Wednesday sent letters to 14 companies, including Exxon … Quebec, resulted in 47 deaths and liability for the accident caused the rail carrier involved to enter … and damages to property and natural resources due to accident involving the release of crude oil; To detail …
https://www.osc.ny.gov/press/releases/2015/06/dinapoli-seeks-information-safety-measures-taken-businesses-involved-shipping-oilDiNapoli Highlights Investment in Rochester Region Through State Pension Fund
… an investment made by the New York State Common Retirement Fund’s (Fund) In-State Private Equity Program. The Fund recently invested in Ambrell through the Hamilton Lane’s … made by the New York State Common Retirement Funds Fund InState Private Equity Program …
https://www.osc.ny.gov/press/releases/2014/06/dinapoli-highlights-investment-rochester-region-through-state-pension-fundDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… The state Department of Health (DOH) could have saved the Medicaid program as much … and struggling with day-to-day life should be informed of their Medicare eligibility, which could reduce their out-of-pocket expenses and may provide them with more options for …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-state-missing-out-millions-medicare-payments-kidney-patientsWestchester Attorney Pleads Guilty to Mail Fraud for Attempting to Embezzle From a Decedent's Estate for Which He Was Court-Appointed Administrator
… in White Plains federal court before U.S. Magistrate Judge Lisa Margaret Smith. "Mr. Parisi tried to steal millions from …
https://www.osc.ny.gov/press/releases/2019/01/westchester-attorney-pleads-guilty-mail-fraud-attempting-embezzle-decedents-estate-which-he-was-courtNew York's Prison Population Continues Decline, But Share of Older Adults Keeps Rising
… The state’s prison population declined by half from March 2008 to March 2021, but the population of individuals aged 50 and above grew slightly, according to a follow-up report … The number of older incarcerated individuals has grown from 7,511 in March 2008 to 7,586 in March 2021. As a …
https://www.osc.ny.gov/press/releases/2022/01/new-yorks-prison-population-continues-decline-share-older-adults-keeps-risingEast Kingston Volunteer Fire Company – Financial Activities (2017M-191)
… Purpose of Audit The purpose of our audit was to evaluate the Company’s financial activities for the period … The Board did not establish policies and procedures for cash receipts, cash disbursements, purchasing goods and … review bank reconciliations, bank statements and canceled check images. The Board did not require the Treasurer to …
https://www.osc.ny.gov/local-government/audits/fire-company-or-department/2017/12/15/east-kingston-volunteer-fire-company-financial-activitiesPersonal Income Tax Refunds
… by the Department of Taxation and Finance (Department) for payment were appropriate and processed in accordance with … prior to payment. We selected Department-approved refunds for examination using filters to identify high-risk … we selected 37,900 refunds totaling almost $480 million for examination. Key Findings Of those transactions selected, …
https://www.osc.ny.gov/state-agencies/audits/2015/04/14/personal-income-tax-refundsUnited HealthCare – Empire Plan Drug Rebate Revenue (Follow-Up)
… made in our audit report, United HealthCare: Empire Plan Drug Rebate Revenue (2016-S-7). Background The New York … district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The New …
https://www.osc.ny.gov/state-agencies/audits/2017/05/15/united-healthcare-empire-plan-drug-rebate-revenue-followLocal Road Conditions in New York State
… about 13 percent of the 192,500 locally owned lane-miles in New York State – a percentage that varies quite a bit from … for every relevant county city town village and borough in New York State …
https://www.osc.ny.gov/local-government/local-road-conditions-new-york-state