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New York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Follow-Up) (2022-F-30)
To assess the extent of implementation of the three recommendations included in our initial audit report, Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Report 2020-S-34).
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2023-22f30.pdfNew York State Health Insurance Program – Payments by CVS Health for Pharmacy Services for Ineligible Members (2020-S-17)
To determine whether CVS Health paid pharmacy claims for Empire Plan members who were not eligible.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2021-20s17.pdfEmpire BlueCross BlueShield Selected Payments for Special Items for the Period July 1, 2011 Through December 31, 2011 (2012-S-3)
To determine whether Empire BlueCross BlueShield (Empire) paid claims for special items according to the provisions of the agreements between Empire and its mem
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2012-12s3.pdfDiNapoli Announces State Contract & Payment Actions for November 2014
… Yonkers Partners in Education, New York City Outward Bound Center and Harlem Center for Education. Department of … to sell prison meals to Saratoga County. Division of Criminal Justice Services $5.2 million in grants to crime labs and …
https://www.osc.ny.gov/press/releases/2014/12/dinapoli-announces-state-contract-payment-actions-november-2014Subway Service Diversions for Maintenance and Capital Projects (Follow-Up)
… Purpose To determine the extent of implementation of the five recommendations included in our initial audit … To determine the extent of implementation of the five recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2015/09/16/subway-service-diversions-maintenance-and-capital-projects-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… Purpose To determine if Empire BlueCross BlueShield: implemented sufficient controls … and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The Empire Plan covers a comprehensive range of services …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… Services Also Covered by Medicare Part B (Report 2012-S-27). Background Many of the State’s Medicaid recipients are … for Services Also Covered by Medicare Part B (2012-S-27) Department of Health: Overpayments for Services Also …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followPension Contribution Rates to Decrease for Fiscal Year 2015-16
… Employer contribution rates for the New York State and Local Retirement System (NYSLRS) will decline in Fiscal Year 2015-16, New York State Comptroller Thomas P. DiNapoli announced … Employer contribution rates for the New York State and Local Retirement System NYSLRS will …
https://www.osc.ny.gov/press/releases/2014/09/pension-contribution-rates-decrease-fiscal-year-2015-16Overpayments for Services Also Covered by Medicare Part B (Follow-Up)
… referred to as "dual eligible." Generally, Medicare is the primary payer of claims for services provided to … on June 20, 2012, examined whether the Department of Health (Department) overpaid health care providers' Medicaid claims for Medicare Part B …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
To determine the extent of implementation of the five recommendations made in our audit report Improper Managed Care Payments for Certain Medicaid Recipients
https://www.osc.ny.gov/state-agencies/audits/2015/01/20/improper-managed-care-payments-certain-medicaid-recipients-followUnnecessary Medicaid Payments for Children at Voluntary Agencies (Follow-Up)
… in place to ensure proper Medicaid payments for foster care children placed in voluntary agencies. The Department … the New York State Medicaid program. Many foster care children who are placed in private welfare agencies … For these children, the State establishes a “Daily Child Care Rate” (Daily Rate), which is the basis for Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followDiNapoli Announces State Contract & Payment Actions for July 2014
… State Comptroller Thomas P. DiNapoli announced today his … million due to fraud, waste or other improprieties. As the state’s chief financial officer, DiNapoli’s office reviews contracts for all state agencies and certain contracts for state public … State Comptroller Thomas P DiNapoli announced today his …
https://www.osc.ny.gov/press/releases/2014/08/dinapoli-announces-state-contract-payment-actions-july-2014Medicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… cost-sharing amounts or indicated UnitedHealthcare did not cover the service. From a review of a sample of 125 claims totaling $151,069, we determined Medicaid overpaid 26 providers $61,711 (40.8 percent) for 54 claims. Most …
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
… Comptroller DiNapoli for his efforts to illustrate the very real human toll that asthma continues to have on New …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-report-finds-medicaid-costs-treating-asthma-risingMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… equipment, such as wheelchairs or oxygen equipment, that can withstand repeated use and have been ordered by a …
https://www.osc.ny.gov/state-agencies/audits/2023/04/12/medicaid-program-excessive-payments-durable-medical-equipment-rentalsEmployment Recovery Is Slow for New Yorkers with Disabilities
… The COVID-19 pandemic led to soaring unemployment rates for people with disabilities, and these rates have not declined as quickly in New York as they have … & Office of Disability Employment Policy. Unemployment rates for people with disabilities similarly show slower …
https://www.osc.ny.gov/reports/employment-recovery-slow-new-yorkers-disabilitiesDiNapoli Announces State Contract & Payment Actions For March 2014
… financial officer, DiNapoli’s office reviews contracts for all state agencies and certain contracts for state public … and payments entered into by the state. This builds on his commitment to added transparency via his Open Book New … Health Benefit Exchange ($29.2 million), the Medicaid and Child Health Plus Insurance Program Enrollment Center ($1.8 …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-announces-state-contract-payment-actions-march-2014Area #4 – Contracts and Service Level Agreements for IT Services – Information Technology Governance
… what format it will be returned and/or whether, when and how it will be destroyed). How shared PII will be protected … quality of those services. Such vaguely worded agreements can, among other things, contribute to confusion over who has … responsibility for various aspects of the IT environment (i.e., the local government/school or service provider), which …
https://www.osc.ny.gov/local-government/publications/it-governance/area-4-contracts-and-service-level-agreements-it-servicesImproper Managed Care Payments for Misclassified Patient Discharges (Follow-Up)
… of implementation of the five recommendations included in our initial audit report, Improper Managed Care Payments … (MCOs) a monthly premium for each enrolled recipient and, in turn, the MCOs arrange for the provision of services for … for transfers and discharges are different and may result in lower payments for transfers. The objective of our initial …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followDiNapoli Announces State Contract & Payment Actions for February 2015
… York City. $27.2 million with H & L Contracting LLC "to address bridge scour in Hempstead and Islip. $24 million with … and Disability Assistance $35 million in federal Home Energy Assistance Program (HEAP) benefits to assist more than …
https://www.osc.ny.gov/press/releases/2015/03/dinapoli-announces-state-contract-payment-actions-february-2015