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Medicaid Program – Opioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program

… certain opioid medications, coupled with counseling and behavioral therapies for people diagnosed with an opioid … bill to modify federal law to allow Treatment Programs to contact other providers to coordinate patient care even … for opioid use disorder. Of those recipients, 493 needed medical care as a result of 691 opioid or narcotic overdoses …

Medicaid Program – Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY

… whether Medicaid made improper payments to providers who submitted Part B cost-sharing claims directly to eMedNY. … is met. After the deductible is met, Medicare begins to pay its share and the enrollee is responsible for any … Questionable payments totaling $5.3 million to providers who claimed excessive Part B coinsurance amounts. …

School for Language and Communication Development – Compliance With the Reimbursable Cost Manual

… To determine whether the costs reported by the School for Language and Communication Development (SLCD) on its … reported on SLCD’s CFR for the fiscal year ended June 30, 2015, and certain expenses reported on SLCD’s CFRs for … not-for-profit special education provider located in Nassau County, New York. SLCD provides preschool special …

UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers

… Purpose To determine whether UnitedHealthcare overpaid for out-of-network anesthesia services provided at Ambulatory … The Empire Plan is the primary health benefits plan for NYSHIP. The Empire Plan provides its members with four … processes and pays claims from health care providers for services provided to Empire Plan members, and Civil …

Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 3, 4, 5 and 6 Members – Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 3, 4, 5 and 6 Members

Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 1 and 2 Members – Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 1 and 2 Members

Medicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance

… through New York State of Health (NYSOH), New York’s online health insurance marketplace, and the remainder were …

UnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)

… Code 59 (Report 2013-S-82 ). Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating local government, and school district … United’s payments to medical providers are based, in part, on procedure codes billed on claims that indicate the medical …

Special 25-Year Plan for Institutional Safety Officers (Sections 89-t and 604(q))

… and Local Retirement System  (Return to Top) … Information for members about special 25 year retirement plan providing an alternative retirement benefit for institutional safety officers and safety and secur …

United HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center

… The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … process and pay medical claims from health care providers for services provided to Empire Plan members. United … pay a nominal co-payment to the participating provider for the services rendered. Members may also choose to receive …

Medicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits

… a pharmacy filled two telephone orders for alprazolam (a drug used to treat anxiety) on the same day for one … for a 30-day supply even though telephone orders for this drug are limited to a five-day supply that can only be …

Special Plan for Suffolk County Park Police Officers (Sections 89-r and 603(n))

… and Local Retirement System (Return to Top) … Information for members about Special Plan for Suffolk County Park Police Officers Sections 89r and 603n …

DiNapoli: State Pays Drug Treatment Center Nearly $4 Million for Ineligible Expenses

… A national drug and alcohol treatment provider was able to collect $3.9 million in ineligible payments due to the processing of invalid claims and inadequate oversight … is included in the final report. The audit can be found online at …

DiNapoli Audit Highlights Need for Better Compliance with School Violence Reporting Law

… The unreported incidents included assaults, bullying, drug use and possession, weapons possession and burglary. … identified by auditors, including an arson and 11 drug possession incidents; Fulton Junior High School reported …

Oversight of Hotels and Motels Used for Homeless and Mixed-Use Temporary Residency

… Purpose To determine if the Office of Temporary and Disability Assistance (OTDA) and the Department of Health (DOH) are adequately ensuring … the overall inspection checklist as well as the inspection function. Establish a process for analyzing the six-month …

Lifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual

… To determine whether the costs reported by Lifeline Center for Child Development, Inc. (Lifeline) on its Consolidated … focused primarily on expenses claimed on Lifeline’s CFR for the fiscal year ended June 30, 2015, and included certain expenses claimed on Lifeline’s CFRs for the two fiscal years ended June 30, 2014. Background …

Brookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual

… With the Reimbursable Cost Manual ( 2015-S-19 ) New York League for Early Learning, Inc.: Compliance With the …

Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)

… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … determined that Davis Ethical likely fabricated nearly all of the improper claims. Davis Ethical processed many of the …

DiNapoli Statement on Greenville Arrest for Alleged Theft of Taxpayer Funded Resources

… following statement regarding the arrest of Terry Williams for alleged theft of fuel from the Town of Greenville Highway … "Mr. Williams allegedly abused his position by taking, for his own personal use, fuel that was meant for official public business and paid for by taxpayers," …

DiNapoli Announces Interim CIO for the New York State Common Retirement Fund

… beneficiaries." "My gratitude goes to Comptroller DiNapoli for his trust and support. We have worked diligently to grow … opportunity to advance the great work we have performed for the Fund in recent years," Titarchuk said. "I look … staff." Titarchuk, who has worked in the financial sector for two decades, joined the Fund in 2011. DiNapoli appointed …