Search
Improper Medicaid Managed Care Payments for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies on Behalf of Recipients in Nursing Homes. (2020-S-61) 180-Day Response
To determine whether Medicaid managed care organizations inappropriately paid for durable medical equipment, prosthetics, orthotics, and supplies while recipients were residing in nursing homes.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2022-20s61-response.pdfOpinion 88-69
… of the municipality to a place for treatment of such illness or injury. Therefore, since section 122-b authorizes …
https://www.osc.ny.gov/legal-opinions/opinion-88-69Medicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… Purpose To determine whether Medicaid made improper fee-for-service … Medicaid provides a wide range of medical services to those who are economically disadvantaged and/or have … providers directly for Medicaid-eligible services rendered to Medicaid recipients. Under the managed care plan method, …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careHuman Resource Practices (Follow-Up) (2021-F-7)
To determine if State University of New York (SUNY) Upstate Medical University has developed and consistently applied policies and procedures related to select human resource functions.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-21f7.pdfOversight of Student Immunization in Schools
… schools in developing policies to prevent and prepare for outbreaks of serious communicable diseases. The … laws and regulations. Additional resources can be located online at SED’s technical assistance center. Schools are … vaccination information for schoolchildren via an online survey (Survey), which all schools complete annually. Survey …
https://www.osc.ny.gov/state-agencies/audits/2016/08/16/oversight-student-immunization-schoolsDiNapoli Releases Bond Calendar for First Quarter
… sales of $5.39 billion include $4.21 billion of new money and $1.18 billion of refundings and reofferings as … scheduled for January, of which $3.57 billion is for new money and $622 million for refunding and reoffering purposes; … million scheduled for February, all of which is for new money purposes; and $743 million scheduled for March, of …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-releases-bond-calendar-first-quarterDiNapoli Releases Bond Calendar for Second Quarter
… New York State Comptroller Thomas P. DiNapoli today announced a tentative schedule for the planned bond sales for the state, New York City and their major public authorities … New York State Comptroller Thomas P DiNapoli today announced a tentative schedule for the planned bond sales for the state …
https://www.osc.ny.gov/press/releases/2020/04/dinapoli-releases-bond-calendar-second-quarterInappropriate 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 Mainstream Managed Care … program. Managed care plans (Plans) receive monthly premium payments for individuals enrolled in their plans. The … made in our initial audit report Inappropriate Premium Payments for Recipients No Longer …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andOpinion 2004-8
… health care benefits of its officers and employees. This is in response to your inquiry concerning a village that … the governing board of the cooperative health benefit plan is required to establish a reserve fund containing amounts … action or judgment for which the municipal corporation is authorized or required to purchase or maintain insurance, …
https://www.osc.ny.gov/legal-opinions/opinion-2004-8DiNapoli: Audit Finds $6.8 Million in Medicaid Overpayments
… overpayments were recovered. “New York’s Medicaid system is vast and complex with plenty of opportunity for waste and … millions in overpayments. To its credit, the department is working to recoup these overpayments and make adjustments … than 50,000 state contracts, visit www.openbooknewyork.com . The easy-to-use website was created by DiNapoli to …
https://www.osc.ny.gov/press/releases/2016/11/dinapoli-audit-finds-68-million-medicaid-overpaymentsXI.6.B Quick Contracting – Construction – XI. Procurement and Contract Management
… To participate in the Office of the State Comptroller’s (OSC) … and established policies The specifications were written to solicit and encourage competition. The agency uses the … required clauses, including Appendix A. The award was made to the lowest responsive and responsible bidder from at least …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi6b-quick-contracting-constructionXII.7.B Voucher Denials – XII. Expenditures
… dates 33 Incorrect or Missing Product Code 34 Incorrect Withholding Information 3M Voucher does not reference the …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii7b-voucher-denialsOverpayments of Certain Medicare Crossover Claims (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations made in our audit report, Overpayments of Certain Medicare Crossover Claims (2011-S-28). Background … To determine the extent of implementation of the five recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2014/12/22/overpayments-certain-medicare-crossover-claims-followOverpayments of Claims for Selected Professional Services (Follow-Up)
… or "edits" are used to detect duplicate claims when one claim is billed as part of the automated crossover system and a second claim is submitted directly to Medicaid for payment. However, the edits did not prevent the duplicate claim payments we identified because each duplicate claim …
https://www.osc.ny.gov/state-agencies/audits/2013/09/23/overpayments-claims-selected-professional-services-followImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… in Hospice Care ( 2017-S-76 ). About the Program Hospice is a program that provides care to terminally ill … all hospice services. However, if a Medicaid recipient is also enrolled in Medicare, Medicare is the primary payer and Medicaid is the secondary payer. In …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followState Comptroller DiNapoli Releases State Audits
… Care Organizations (MCOs) are contractually required to submit encounter transactions to inform DOH about each medical service provided to their enrolled recipients. Auditors found most Medicaid … Managed Care Organizations MCOs are contractually required to submit encounter transactions to inform DOH about each …
https://www.osc.ny.gov/press/releases/2016/04/state-comptroller-dinapoli-releases-state-auditsOpinion 98-9
… must receive those services without a fee or charge. This is in response to your inquiry concerning the imposition of … first aid squad of a fire department or fire company which is subject to the provisions of section two hundred nine-b of … Law, §198[10-f][b]; see also 1993 Opns St Comp No. 93-26, p 46). The above-mentioned provisions were added to the …
https://www.osc.ny.gov/legal-opinions/opinion-98-9UnitedHealthcare: Improper Payments for Medical Services Designated By Modifier Code 59 (2013-S-82), 90-Day Response
To determine whether UnitedHealthcare improperly paid for medical services designated with modifier code 59 that were not distinct and independent from other se
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2015-13s82-response.pdfApproved State Contracts and Payments
… based residential program grants, including $1.5 million to Pathways Renewed Inc., $1.1 million to Bridges of Greater NY Inc., and $1 million to Rescue Mission of Utica. Governor's Office of Employee …
https://www.osc.ny.gov/press/releases/2017/10/approved-state-contracts-and-paymentsComptroller DiNapoli Calls on Major Corporations to Report on Disability Inclusion
… of choice. The deadline for participating in the 2019 DEI is January 31 and any inquiries can be sent to … . “Including people with disabilities in the workplace is not just the right thing to do – it’s also good business,” … in the work force. Corporate participation in the DEI is a concrete step for executives to communicate to investors …
https://www.osc.ny.gov/press/releases/2019/01/comptroller-dinapoli-calls-major-corporations-report-disability-inclusion