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West Corners Fire Company – Accounting for Cash Receipts and Disbursements (2014M-215)

… ensured that the Treasurer was properly accounting for cash receipts and disbursements for the period January 1, 2013 through May 16, 2014. … that is located in, and provides fire protection services for, the Town of Union in Broome County. The Company’s …

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

… must recoup this money, which should have been used for cost-effective addiction services to New Yorkers.” OASAS, which oversees one of the nation’s largest programs for the prevention and treatment of alcohol and substance … area. The state’s contract with PHNY was renewed in 2014 for another five-year term (July 1, 2014 through June 30, …

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

… to take steps toward providing a safe learning environment for students in pre-kindergarten through 12th grade. Under … and codes of conduct, and develop emergency response plans for each building. To comply with the SAVE Act, SED requires … incidents. DiNapoli’s auditors reviewed incident records for seven schools outside of New York City for the 2011-12 …

Monitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance (Follow-Up)

To determine the extent of implementation of the four recommendations included in our initial audit report Monitoring of NotforProfit Cemeteries for Fiscal Stability and Adequate Facility Maintenance 2016S79

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

… Medicaid recipients who are receiving opioids while also in a Treatment Program for opioid use disorder. This audit … 25 recipients were asked at least once during treatment to sign a consent form to coordinate care with the recipient’s … prescriber. However, 3 of the 13 recipients declined to sign a consent form. We found care coordination with regard …

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

… period from June 1, 2012 through May 31, 2017. Background Many of the State’s Medicaid recipients are also eligible for … to minimize the need for providers to self-report Medicare claim data to eMedNY and thereby improve the accuracy of … still submit these claims directly to eMedNY for payment (i.e., self-report Medicare data). In these situations, the …

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

… whether the costs reported by the School for Language and Communication Development (SLCD) on its Consolidated … (CFR) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) … The ineligible costs included: $28,271 in pension benefits for administrative employees that exceeded the …

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 …

Children’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual

… To determine whether the costs reported by Children’s Unit for Treatment and Evaluation (CUTE) on its Consolidated … for these services through rates set by SED. The reimbursement rates are based on financial information, … CUTE reports to SED on its annual CFR. To be eligible for reimbursement, reported costs must comply with the RCM …

Educators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)

… grant contracts for the period July 1, 2002 through June 4, 2008. New York State awards grants and contracts to …

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

… their members require. As of August 2017, 4.4 million people were enrolled in mainstream managed care plans – about … the Department’s policy is to exclude Medicaid recipients from mainstream managed care when they have concurrent … inappropriate managed care premiums. Implement controls to remove non-NYSOH-enrolled recipients with comprehensive TPHI …

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 … Service (Department) 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 …

Changes in Federal Policies Pose Significant Risks for New York City's Budget

… Projected budget gaps for New York City in the coming years appear manageable, but tax changes and … difficult times may lie ahead, depending on the effects of what happens in Washington." The November update to the … visit Open Book New York . The easy-to-use website was created by DiNapoli to promote transparency in government …

Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber

… to matters addressing the Doctor’s prescribing activity for the period January 1, 2013 through June 30, 2016. Background The Department is responsible for administering New York State’s Medicaid program. Medicaid … disadvantaged and/or have special health care needs. For the State fiscal year ended March 31, 2016, New York’s …

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 … to provide information on any actions that are planned to address the unresolved issues discussed in this report. Other …

Medicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care

… Purpose To determine whether Medicaid made improper fee-for-service claim payments for pharmacy services covered by recipients’ managed care … program pays medical providers through either the fee-for-service method or the managed care plan method. Under 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

… Thomas P. DiNapoli today announced his appointment of Anastasia Titarchuk as Interim Chief Investment Officer of the New York State Common Retirement Fund. The Fund’s … State Common Retirement Fund is the third largest public pension fund in the United States, with an audited value of …