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Medicaid Program – Improper Payments for Certain Third-Party Cost-Sharing Claims
… Group codes include PR (patient responsibility) and CO (contractual obligation). CARC 45 occurs when the charge … configured to pay in eMedNY, while claims with a CARC CO 45 are not. All claims submitted for Medicaid members with Medicare and/or other third-party insurance must accurately reflect payments, adjustments …
https://www.osc.ny.gov/state-agencies/audits/2025/11/05/medicaid-program-improper-payments-certain-third-party-cost-sharing-claimsDiNapoli Announces State Contract & Payment Actions For March 2014
… Administration contract with WDF Inc. to construct the NYC Court Officer Training Academy. Approved a $27.8 million … County $306,000 Village of Afton $248,000 Deferred Compensation Board Approved a $43.2 million contract with …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-announces-state-contract-payment-actions-march-2014Medicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
… Part C, private managed care companies administer Medicare benefits. These Medicare Advantage Plans typically have … Part C cost-sharing liabilities (deductibles, coinsurance, and copayments). Key Finding From a review of Medicare Part C … copayments, or deductibles. Ten providers adjusted and re-submitted their claims to eMedNY resulting in Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2015/01/16/medicaid-program-medicaid-overpayments-certain-medicare-part-c-claimsDiNapoli Releases New Tool for Monitoring NYC 311 Complaints
… Non-emergency 311 calls have increased dramatically in New York City since the COVID-19 pandemic. To increase … 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-complaintsDiNapoli Report Finds Medicaid Costs for Treating Asthma Rising
… for Disease Control and Prevention (CDC). New York's $55 billion Medicaid program enrolls approximately one in four … WF- Manhattan/Bronx): "The communities I represent in the South Bronx and East Harlem have unfortunately been facing a … higher for children up to age17 and adults aged 55 and over, reinforcing the need in communities such as East …
https://www.osc.ny.gov/press/releases/2014/04/dinapoli-report-finds-medicaid-costs-treating-asthma-risingSubway Service Diversions for Maintenance and Capital Projects (Follow-Up)
… in our initial audit report, Subway Service Diversions for Maintenance and Capital Projects ( 2010-S-34 ). … that while Transit has a number of policies and procedures for managing and controlling subway diversions, more needed … not planned using current ridership data, and the budget for diversion advertisements to communicate information about …
https://www.osc.ny.gov/state-agencies/audits/2015/09/16/subway-service-diversions-maintenance-and-capital-projects-followThe Survivor’s Benefit Program for New York State Employees
… requirements? There is no need to enroll — your beneficiary is eligible to receive this benefit if, at the … and prior to the effective date of your retirement, your beneficiary may still be eligible to collect a benefit. Note … your retirement system. (Return to Top) How much will my beneficiary receive? The amount of the benefit varies …
https://www.osc.ny.gov/retirement/publications/survivors-benefit-program-nys-employeesEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… range of services including, but not limited to, hospital services, office visits, home care, medical equipment, mental health services, and prescription drugs. The State … rate schedules for the payment of inpatient and outpatient hospital services. Empire’s hospital contracts also allow …
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)
… Purpose To determine the extent of implementation of the two recommendations made in our audit report, … by Medicare Part B (Report 2012-S-27). Background Many of the State’s Medicaid recipients are also enrolled in … To determine the extent of implementation of the two recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2015/06/26/overpayments-services-also-covered-medicare-part-b-followImproper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
… extent of implementation of the five recommendations made in our audit report, Improper Managed Care Payments for … years ended June 30, 2010, Medicaid made $15.6 million in improper managed care payments on behalf of 14,899 … who, by State law, were precluded from enrollment in managed care programs. We recommended that the Department …
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)
… Purpose To determine the extent of implementation of the five recommendations made in our audit report, … To determine the extent of implementation of the five recommendations made in our …
https://www.osc.ny.gov/state-agencies/audits/2014/10/23/unnecessary-medicaid-payments-children-voluntary-agencies-followOverpayments for Services Also Covered by Medicare Part B (Follow-Up)
… by Medicare Part B (2010-S-50). Background Many of the State's Medicaid recipients are also eligible for Medicare … by Medicare. Our initial audit report, which was issued on June 20, 2012, examined whether the Department of Health … providers did not properly report Medicare payment data on those claims. Key Findings Department officials made …
https://www.osc.ny.gov/state-agencies/audits/2014/03/06/overpayments-services-also-covered-medicare-part-b-followDiNapoli Announces State Contract & Payment Actions for July 2014
… Bridge project. $7.8 million contract with STV Inc. for construction management services for the Kosciuszko Bridge … of the General Services $3 million contract with Rosemar Construction Inc. to modernize the flight line area at the … $5.2 million for capital improvements to Ralph Wilson Stadium, home of the Buffalo Bills. State Education …
https://www.osc.ny.gov/press/releases/2014/08/dinapoli-announces-state-contract-payment-actions-july-2014DiNapoli: Bombay Clerk Sentenced for Pocketing Justice Court Fees
… A North Country court clerk was sentenced yesterday for stealing more than $5,680 from Bombay Justice … 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 …
https://www.osc.ny.gov/press/releases/2017/05/dinapoli-bombay-clerk-sentenced-pocketing-justice-court-feesArea #4 – Contracts and Service Level Agreements for IT Services – Information Technology Governance
… Local governments and schools often rely on third parties to provide a variety of IT-related services. For your … what format it will be returned and/or whether, when and how it will be destroyed). How shared PII will be protected … provider could, for example, indicate that you will have availability to an application 99.95 percent of the time …
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)
… judgmental sample of 166 claims, totaling $2,474,162, from six hospitals, and reviewed the associated patients’ medical …
https://www.osc.ny.gov/state-agencies/audits/2023/12/06/improper-managed-care-payments-misclassified-patient-discharges-followMedicaid Program – Excessive Payments for Durable Medical Equipment Rentals
… (or caps). A special category of DME – oxygen equipment – is only available for rental and generally has no limit on …
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
… disabilities, and these rates have not declined as quickly in New York as they have nationally. 1 In addition, the national share of people with disabilities who are working reached a new high in 2022, while the share in New York continued to decline … disabilities and these rates have not declined as quickly in New York as they have nationally …
https://www.osc.ny.gov/reports/employment-recovery-slow-new-yorkers-disabilitiesXI.10 Third Party Contracting - Contracting "for" the State – XI. Procurement and Contract Management
… A Third Party Contract is one in which a state agency enters into a contract with another entity (the “State Contractor”) where … A Third Party Contract is one in which a state agency enters into a …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi10-third-party-contracting-contracting-stateXI.11.H Early Pay Discounts for Procurement Contract Purchases – XI. Procurement and Contract Management
… Agencies are encouraged to request early pay discounts from contract vendors when feasible. If early pay discount … Agencies are encouraged to request early pay discounts from contract vendors when feasible …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi11h-early-pay-discounts-procurement-contract-purchases