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Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… Objective To assess the extent of implementation of the nine … are enrolled in both Medicaid and Medicare (referred to as dual-eligibles), Medicare is the primary payer for …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial … picked-up the drugs billed to Medicaid. Moreover, as a result of our audit, we concluded that Davis Ethical … Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11) United HealthCare …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… services covered by recipients’ managed care plans. The audit covered the period October 1, 2011 through December … services to those who are economically disadvantaged and/or have special health care needs. In general, the Medicaid program pays …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up)
… wish to stay in their homes and communities. MLTC plans offer a range of services, such as home health care, nursing …
https://www.osc.ny.gov/state-agencies/audits/2021/08/31/improper-fee-service-payments-services-covered-managed-long-term-care-plans-followMedicaid Program – Improper Fee-for-Service Payments for Services Covered by Long-Term Care Plans
… (FFS) payments for certain services covered by managed long-term care (MLTC) plans. The audit covered the … services. The Medicaid program should not pay claims on a FFS basis for services covered by MLTC plans. Individuals … Local Departments of Social Services (Local Districts) or a contractor that operates a statewide enrollment center for …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/medicaid-program-improper-fee-service-payments-services-covered-long-term-care-plansDiNapoli: State's Pandemic Response to Nursing Homes Hindered by Ill-Prepared State Agency
… geographic trends, and emerging infectious diseases or to shape its infection control policies. It also relies heavily …
https://www.osc.ny.gov/press/releases/2022/03/dinapoli-states-pandemic-response-nursing-homes-hindered-ill-prepared-state-agencyMedicaid Program – Accuracy of Medicaid Eligibility Determined by NY State of Health
… Objective To determine whether NY State of Health (NYSOH, New York’s online health plan … 1, 2014 through February 28, 2020. About the Program The Department of Health (Department) administers New York’s …
https://www.osc.ny.gov/state-agencies/audits/2020/09/17/medicaid-program-accuracy-medicaid-eligibility-determined-ny-state-healthMedicaid Program – Overpayments for Therapy Services and Prescription Drugs Covered by Medicare
… Many of the State’s Medicaid recipients are also enrolled in Medicare. Such individuals are referred to as … Medicaid. Key Findings The audit identified $20.1 million in Medicaid payments for services provided to dual-eligible … by Medicaid. Key Recommendations Review the $20.1 million in Medicaid payments for therapy services and prescription …
https://www.osc.ny.gov/state-agencies/audits/2019/10/30/medicaid-program-overpayments-therapy-services-and-prescription-drugs-covered-medicareUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… costs, and if so, to quantify the overpayments made by United HealthCare resulting from this practice. The audit … is the primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital care to … medical services to Empire Plan members. Members pay a nominal co-payment to the participating provider for the …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… whether Orthopedic Associates of Long Island, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to … and school district employees and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandReporting Services Provided by Lawyers and Law Firms (Education Law Section 2053)
… School districts and Boards of Cooperative Educational Services (BOCES) are required by … requires certain information to be filed with the Office of the Attorney General, the Office of the State Comptroller and the State Education Department. …
https://www.osc.ny.gov/retirement/employers/reporting-services-provided-lawyers-and-law-firms-education-law-section-2053SUNY Bulletin No. SU-342
… bulletin is to inform agencies of the implementation of Paid Parental Leave for certain State University of New York … and provide guidance for entering the leave transactions in PayServ. Affected Employees All eligible employees meeting …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-university-new-york/su-342-suny-paid-parental-leave-fullDiNapoli: Improved Guidance Needed for State Agencies Using AI To Avoid Risks
… that are meant to help expedite and expand services can, for example, expose data to unintended sources and … of AI explicitly considers a system using computer vision (i.e., that gathers information from digital images) and … metric data and recorded data, and that the vendor can use and access this data. NYSOFA officials did not know …
https://www.osc.ny.gov/press/releases/2025/04/dinapoli-improved-guidance-needed-state-agencies-using-ai-avoid-risksFranklin County – Internal Controls Over the Timekeeping System (2014M-276)
… County is located in northeastern New York and has a population of approximately 51,600. The County is governed by the County Legislature which is comprised of seven … Ensure that all overtime is approved prior to the work being performed. Ensure that employees charge leave time when …
https://www.osc.ny.gov/local-government/audits/county/2015/01/30/franklin-county-internal-controls-over-timekeeping-system-2014m-276State Comptroller Thomas P. DiNapoli Statement on IDA Reform Legislaton (S.5867/A.7915)
… “New York is in a better position to evaluate Industrial Development Agencies and the projects … efficiency and transparency of the operations of our IDAs. I also want to recognize the New York Economic Development Council …
https://www.osc.ny.gov/press/releases/2015/12/state-comptroller-thomas-p-dinapoli-statement-ida-reform-legislaton-s5867a7915Weedsport Central School District – Payroll (2021M-179)
… and/or did not have proper supporting documentation. The payroll clerk was not provided with supporting documentation … attention. District officials did not properly segregate payroll processing duties and did not provide adequate … Provide adequate supporting documentation for payroll processing. Assign personnel and payroll processing …
https://www.osc.ny.gov/local-government/audits/school-district/2022/07/01/weedsport-central-school-district-payroll-2021m-179Mount Markham Central School District – Reserve Funds (2016M-73)
… The Mount Markham Central School District is located in a number of towns in Herkimer, Madison, Oneida and Otsego … schools with approximately 1,055 students, is governed by an elected seven-member Board of Education. Budgeted … reserve policy that communicates to residents why money is being set aside, the Board’s financial objectives for each …
https://www.osc.ny.gov/local-government/audits/school-district/2016/06/24/mount-markham-central-school-district-reserve-funds-2016m-73DiNapoli: New Jersey Man Pleads Guilty to Embezzling From a Decedent's Estate for Which He Was Court-Appointed Administrator
… Comptroller Thomas P. DiNapoli, United States Attorney for the Southern District of New York, Geoffrey S. Berman and Philip R. Bartlett, Inspector-in-Charge of the New York … faces significant prison time for his crimes." "Instead of being satisfied with the fees the law prescribed as an estate …
https://www.osc.ny.gov/press/releases/2018/10/dinapoli-new-jersey-man-pleads-guilty-embezzling-decedents-estate-which-he-was-court-appointedXIX.4 Suballocations – XIX. Project Costing (PCIP)
… suballocated project work is for the same project, per the definition of a project, then there is no need for a new … project work is for the same project activities, per the definition of an activity, and the funding source does not …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xix/xix4-suballocationsXII.5.C Selecting the Appropriate Vendor and Address Sequence – XII. Expenditures
… receive payment. If vendors are unable to receive or post State payments, it may delay payment crediting and Business … payment request will meet the processing needs of both New York State and the vendor. Section 6.Z - Processing Payments …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii5c-selecting-appropriate-vendor-and-address-sequence