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UnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59
… 1, 2012 to August 31, 2013. Background The New York State Health Insurance Program (NYSHIP) provides health insurance … the NYSHIP program and contracts with UnitedHealthcare (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s payments to medical providers are based, in part, on …
https://www.osc.ny.gov/state-agencies/audits/2015/01/08/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59Medicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
… enrolled recipients. The Department uses encounter data for numerous purposes, including, but not limited to, quality … Accountability Act-compliant transaction sets (one each for professional, institutional, dental, and pharmacy … 10 of 52 Medicaid MCOs had successfully completed testing for the new system, including all four transaction sets. An …
https://www.osc.ny.gov/state-agencies/audits/2016/03/29/medicaid-program-managed-care-organizations-readiness-encounter-intake-systemDiNapoli: Tennessee Woman Sentenced for Stealing Deceased Mother's NYS Pension Checks
… sentencing of Leslie Schwinzer, of Knoxville, Tennessee, for stealing pension checks that had been issued to her … over $56,000 in restitution and serve eight months home detention and two years’ probation before the Honorable Thomas A. Varlan in United States District Court for the Eastern District of Tennessee at Knoxville. …
https://www.osc.ny.gov/press/releases/2022/07/dinapoli-tennessee-woman-sentenced-stealing-deceased-mothers-nys-pension-checksXIII.11 Submitting Travel and Expense Reimbursement Requests for Inactive Employees – XIII. Employee Expense Reimbursement
… on submitting Travel and Expense reimbursement requests for inactive employees for expenses that were incurred during the employee’s State … be expedited. Guide to Financial Operations REV. 01/14/2020 … The purpose of this section is to provide guidance to …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xiii/xiii11-submitting-travel-and-expense-reimbursement-requests-inactive-employeesDiNapoli: Former Potter Town Clerk Arrested for Theft of Nearly $24,000
… Yates County Sherriff Ronald Spike announced the arrest of Julie Brown, former clerk of the Town of Potter. Brown, 49, was arrested Friday for allegedly …
https://www.osc.ny.gov/press/releases/2020/11/dinapoli-former-potter-town-clerk-arrested-theft-nearly-24000DiNapoli: Former Riverside Village Clerk Sentenced to Jail for $50K Theft
… DiNapoli announced today. Johnson was sentenced to 60 days in jail, five years probation and ordered to pay full … repay taxpayers.” Johnson pleaded guilty to grand larceny in Steuben County Court in March. DiNapoli’s audit and investigation found that for …
https://www.osc.ny.gov/press/releases/2015/06/dinapoli-former-riverside-village-clerk-sentenced-jail-50k-theftGASB Statement No. 33 "Accounting and Financial Reporting for Nonexchange Transactions"
… No. 33 provides accounting and reporting guidelines for nonexchange transactions. A nonexchange transaction is … this bulletin is to discuss the Statement No. 33 impact on revenue recognition when using the modified accrual basis of …
https://www.osc.ny.gov/local-government/publications/gasb-statement-no-33-accounting-and-financial-reporting-nonexchange-transactionsOpioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program (Follow-Up)
… included in our initial audit report, Opioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program … opioid medications and counseling and behavioral therapies for people diagnosed with an opioid use disorder. The State … prescription drug use, known as the Internet System for Tracking Over-Prescribing (I-STOP), which contains …
https://www.osc.ny.gov/state-agencies/audits/2020/05/07/opioid-prescriptions-medicaid-recipients-opioid-treatment-program-followDiNapoli and Hein Announce Training For Fire Districts and EMS Agencies
… County Executive Michael P. Hein, on financial safeguards for fire districts in Ulster County. “Fire district … DiNapoli’s office to offer an internal controls training for all fire services,” said Ray Preziosi, President, … Office, this training will be a valuable tool for all fire departments.” The move comes after DiNapoli’s …
https://www.osc.ny.gov/press/releases/2015/06/dinapoli-and-hein-announce-training-fire-districts-and-ems-agenciesCity of Long Beach - Payments for Unused Leave Accruals (2019M-68)
… whether payments to certain City officers and employees for unused leave accruals were authorized and accurately … agreements (CBAs). The City approved drawdown payments for unused leave accruals, totaling $229,494 to eight City … from service. In the absence of specific authorization for such payments, we question the appropriateness of …
https://www.osc.ny.gov/local-government/audits/city/2019/12/11/city-long-beach-payments-unused-leave-accruals-2019m-68DiNapoli: Former Director Allegedly Stole $1,700 From Hornell Partners for Growth
… The former Executive Director of Hornell Partners for Growth (HPG) was charged with Grand Larceny in the Fourth … Degree and Falsifying Business Records in the First Degree for allegedly stealing $1,711 in cash from the HPG’s Annual Fourth of July festival and earmarked for the city’s Business Improvement District, according to …
https://www.osc.ny.gov/press/releases/2020/01/dinapoli-former-director-allegedly-stole-1700-hornell-partners-growthManaged Care Premium Payments for Recipients With Comprehensive Third-Party Insurance (Follow-Up)
… our initial audit report, Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance … Recipients should, instead, be enrolled in Medicaid fee-for-service to avoid the expense of monthly managed care premiums (for instance, under fee-for-service, after the comprehensive …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/managed-care-premium-payments-recipients-comprehensive-third-party-insurance-followDebt Approvals for Public Authorities, Municipalities, School Districts and District Corporations
… Form”). The Guidelines summarize the process and criteria for the State Comptroller's review of the terms and …
https://www.osc.ny.gov/debt/approvalsAll Services for Kids, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by All Services for Kids, Inc. (All Services) on its … to the State Education Department's (SED) Reimbursable Cost Manual (Manual). The audit covered the two fiscal years … (SEIT) to children with disabilities between the ages of three and five. The New York City Department of Education …
https://www.osc.ny.gov/state-agencies/audits/2014/02/25/all-services-kids-inc-compliance-reimbursable-cost-manualDiNapoli: Audits Reveal Millions in Lost Revenue for Local Water Systems
… are straining municipal finances and increasing costs for taxpayers. If these problems aren't addressed, the issues … being improperly used to subsidize general operating costs for municipalities; The lack of adequate monitoring of system … oversight of water testing, identifying opportunities for improvement. In addition, upcoming audits are planned …
https://www.osc.ny.gov/press/releases/2017/10/dinapoli-audits-reveal-millions-lost-revenue-local-water-systemsMedicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
… Health established adequate controls over inpatient claims for recipients who were transferred between merged or … responsibilities include establishing Medicaid policies for reimbursing hospitals and other health care providers for their services. Generally, when a Medicaid recipient is …
https://www.osc.ny.gov/state-agencies/audits/2015/12/08/medicaid-overpayments-inpatient-transfer-claims-among-merged-or-consolidated-facilitiesCharter School for Applied Technologies – Payment to Affiliated Entities (2013M-300)
… with its affiliated entities and any related payments for the period July 1, 2010 through January 11, 2013. … private entities which the Board caused to be established for the purpose of enabling the School to engage in what are … entity’s financial records. The School made payments for services to one of the entities without a written …
https://www.osc.ny.gov/local-government/audits/school-district/2014/01/17/charter-school-applied-technologies-payment-affiliated-entities-2013m-300Albany Leadership Charter High School for Girls – Professional Services (2013M-283)
… contract with the Brighter Choice Foundation (Foundation) for the period July 1, 2011 through May 31, 2013. Background The Albany Leadership Charter High School For Girls, located in the City of Albany, Albany County, is … voting members. The School’s budgeted operating expenses for the 2012-13 fiscal year totaled approximately $4.7 …
https://www.osc.ny.gov/local-government/audits/charter-school/2014/01/17/albany-leadership-charter-high-school-girls-professional-services-2013mBrighter Choice Charter Middle School for Girls – Financial Operations (2014M-301)
… the effectiveness of the School’s contract with a not-for-profit foundation for the period July 1, 2011 through June 30, 2014. Background The Brighter Choice Charter Middle School for Girls is a public school that is not under the control of …
https://www.osc.ny.gov/local-government/audits/charter-school/2015/03/06/brighter-choice-charter-middle-school-girls-financial-operations-2014m-301DiNapoli: As State Tax Check-Off Options Increase, Spending Lags for Most
… New York state has the highest number of personal income tax (PIT) check-offs in … of taxpayers donating to these funds has declined over time. In SFY 1983-84, the first year a tax check-off option appeared, there were over …
https://www.osc.ny.gov/press/releases/2024/01/dinapoli-state-tax-check-off-options-increase-spending-lags-most