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Medicaid Program – Improper Medicaid Payments for Misclassified Patient Discharges
… to reimburse hospitals for inpatient medical care. When a hospital bills Medicaid for an inpatient stay, the hospital reports certain information on its claims, such as … information is used to calculate the payment made to the hospital. Hospitals must also use certain patient status …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-misclassified-patient-dischargesDiNapoli: Former School District Treasurer Sentenced for Stealing Funds
… shopping,” DiNapoli said. “She was wrong and now she must face the consequences of her actions. My thanks to Acting … State Police and was prosecuted by the U.S. Attorney's Office for the Northern District. Since taking office in 2007, DiNapoli has committed to fighting public …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-former-school-district-treasurer-sentenced-stealing-fundsUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… rate schedules that did not correlate with the date of the service on the claims, and to calculate the … Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance … United to administer the medical/surgical benefits portion of the Empire Plan. United contracts with in-network …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsImplementation of the Dignity for All Students Act (Follow-Up)
… Students Act (Report 2016-S-28 ). About the Program New York State’s Dignity for All Students Act (DASA) seeks to provide students in New York with a safe and supportive environment free from … year ended June 30, 2018, school districts (excluding New York City) reported 15,826 incidents statewide under …
https://www.osc.ny.gov/state-agencies/audits/2019/11/21/implementation-dignity-all-students-act-followMaximizing Drug Rebates for Health and Recovery Plans (Follow-Up)
… in our initial audit report, Maximizing Drug Rebates for Health and Recovery Plans (Report 2017-S-61 ). About the Program … appropriate steps to collect all available drug rebates for HARPs. The audit covered the period October 1, 2015 …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/maximizing-drug-rebates-health-and-recovery-plans-followDiNapoli Releases Fiscal Stress Scores for Villages and Cities
… of “significant fiscal stress,” 73 villages and cities have not filed their financial information, as required. … the fiscal health of 522 villages, which predominantly have a fiscal year ending on May 31, based on self-reported data for 2021. The scores …
https://www.osc.ny.gov/press/releases/2022/04/dinapoli-releases-fiscal-stress-scores-villages-and-citiesImproper Medicaid Payments for Recipients in Hospice Care (Follow-Up)
… provides care to terminally ill individuals, with a focus on easing symptoms rather than treating the disease. … because the Department of Health (Department) did not have a process to identify and track Medicaid recipients … Consequently, the eMedNY claims processing system did not have controls to prevent payments to non-hospice providers …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/improper-medicaid-payments-recipients-hospice-care-followUse of Federal Funding for Election Technology and Security
… Act Election Security Grant to enhance the security of the State’s election technology and infrastructure. The audit … the BOE supports 57 County Boards of Elections and the New York City Board of Elections (County Boards). Congress passed …
https://www.osc.ny.gov/state-agencies/audits/2021/09/17/use-federal-funding-election-technology-and-securityBenefits Advisement Services for Individuals With Disabilities Seeking Employment
… Mental Health (OMH) has effectively addressed the findings and recommendation related to benefits advisement in the New … was about 33 percent compared to about 75 percent for people without disabilities. Further, ACS data shows that … may not be receiving notifications on important benefits for which they may be eligible, as notifications are …
https://www.osc.ny.gov/state-agencies/audits/2021/07/20/benefits-advisement-services-individuals-disabilities-seeking-employmentDiNapoli: Westchester Sisters Sentenced for Stealing Deceased Mother's Pension
… and Mary Nash hid their mother’s death and tried to cheat the state retirement system,” DiNapoli said. “Now they …
https://www.osc.ny.gov/press/releases/2021/02/dinapoli-westchester-sisters-sentenced-stealing-deceased-mothers-pensionRegulation for Scheduling, Adjourning and Conduct of Administrative Hearings
… other parties and all counsel, if any, when a hearing on the application will be held. (b) All notices of hearings … state of New York. (b) All parties may present witnesses on their behalf. All witnesses shall testify under oath or by … hearing proceeding will be closed. (c) After all parties have rested, and received a copy of the record; the parties …
https://www.osc.ny.gov/retirement/members/regulation-for-hearingsMedicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… identify Medicaid overpayments made to medical providers for services rendered to recipients enrolled in … of participating providers they reimburse directly for services provided to enrollees. For dual-eligibles, plan … Part C cost-sharing liabilities (deductibles, coinsurance, and copayments). Key Finding From a review of Medicare Part C …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsDiNapoli Report Finds Medicaid Costs for Treating Asthma Rising
… 559,000 diagnosed with asthma, and spent $532 million on asthma care in 2013. For Medicaid recipients, New York's … communities I represent in the South Bronx and East Harlem have unfortunately been facing a full-blown asthma epidemic … report demonstrates that we still have a lot of work to do to reduce the burden of asthma across the state." For a …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-report-finds-medicaid-costs-treating-asthma-risingDiNapoli Announces State Contract & Payment Actions For March 2014
… Approved an $865,000 OTDA contract to Make the Road NY to provide legal services in Staten Island with a focus on … affected by flooding: Town of Vestal $7.7 million Owego County $4.7 million Village of Owego $2.7 million Binghamton $2.6 million …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-announces-state-contract-payment-actions-march-2014DiNapoli: Bombay Clerk Sentenced for Pocketing Justice Court Fees
… Court while the other court clerk – his mother – was on sick leave, according to State Comptroller Thomas P. … spending, public authority financial data and information on 1300,000 state contracts, visit Open Book New York . The … Justice Court while the other court clerk his mother was on sick leave according to State Comptroller Thomas P DiNapoli …
https://www.osc.ny.gov/press/releases/2017/05/dinapoli-bombay-clerk-sentenced-pocketing-justice-court-feesDiNapoli & NYC Make it Easier to Save for College
… to attend college. We're grateful to New York City and to NYC Kids RISE for their efforts to increase college … Office of the State Comptroller by the Mayor's Office and NYC Kids RISE. "The elimination of the minimum contribution … the Mayor's Office of Media and Entertainment and chair of NYC Kids RISE . "The NYC Kids RISE Save for College Program …
https://www.osc.ny.gov/press/releases/2017/09/dinapoli-nyc-make-it-easier-save-collegeXI.10 Third Party Contracting - Contracting "for" the State – XI. Procurement and Contract Management
… (such as true subcontracts) under arrangements that do not create an agent-like relationship are not contracts … Contractor where the State Contractor agrees to procure, on an as-needed basis, various types of administrative … are responsible for ensuring that third party contractors have valid NYS Vendor IDs. If a NYS Vendor ID does not exist …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi10-third-party-contracting-contracting-stateDiNapoli Releases New Tool for Monitoring NYC 311 Complaints
Nonemergency 311 calls have increased dramatically in New York City since the COVID19 pandemic
https://www.osc.ny.gov/press/releases/2025/05/dinapoli-releases-new-tool-monitoring-nyc-311-complaintsNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
… of implementation of the four recommendations included in our initial audit report, New York State Health Insurance … NYBEAS disenrollment is entered after the date the change in eligibility takes effect, it is considered a retroactive … The objective of our initial audit report, issued on May 13, 2022, was to determine whether Carelon paid MHSU …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andDiNapoli: Queens Woman Sentenced to Probation and Pays Full Restitution for Stealing $85,000 in NYS Pension Payments Meant for Her Deceased Father
… in April 2020, at which time, the pension payments should have stopped. In July 2022, the state retirement system … of personal purchases and spent an additional $14,914 on payments to the management company of her father’s …
https://www.osc.ny.gov/press/releases/2024/12/dinapoli-queens-woman-sentenced-probation-and-pays-full-restitution-stealing-85000-nys-pension