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Medicaid Program – Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY
… Medicaid made improper payments to providers who submitted Part B cost-sharing claims directly to eMedNY. The audit … The Medicare program has multiple parts. Medicare Part B provides supplementary medical insurance coverage for … Medicare enrollees are responsible for paying all costs of Part B services until their annual deductible is met. After …
https://www.osc.ny.gov/state-agencies/audits/2018/12/11/medicaid-program-medicaid-overpayments-medicare-part-b-services-billed-directly-emednyPlainview-Old Bethpage Central School District - Retiree Health Insurance (2018M-148)
… Establish a process to periodically monitor the status of all retirees and their spouses and dependents receiving …
https://www.osc.ny.gov/local-government/audits/school-district/2018/09/21/plainview-old-bethpage-central-school-district-retiree-health-insuranceImproper Supplemental Maternity Capitation Payments to Managed Care Organizations (Follow-Up)
… pays managed care organizations (MCOs) a monthly premium for each enrolled recipient and, in turn, the MCOs pay for … services their members require. In addition to the monthly premiums, MCOs can receive a one-time Supplemental Maternity … data to verify that SMCP claims were eligible for reimbursement. Instead, the Department relied on audits by …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/improper-supplemental-maternity-capitation-payments-managed-care-organizations-followExcessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… Purpose To determine the extent of implementation of the three recommendations included in our initial audit … provided to dual eligible individuals. About $500 million of this amount occurred because the Department did not ensure … Determine the extent of implementation of 3 recommendations incld in our initial …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followState Comptroller DiNapoli Releases Audits
… than 10 percent of the penalty amount examined. This includes up to 1,679 penalties valued at $307,753 that … payments. Department of Health (DOH): Medicaid Payments to Medicare Advantage Plan Providers (2016-S-54) Auditors reviewed …
https://www.osc.ny.gov/press/releases/2018/09/state-comptroller-dinapoli-releases-audits-0Comptroller DiNapoli Releases State Audits
… central office. Port Authority of New York and New Jersey: Contracts for Personal and Miscellaneous Services … determined that the Port Authority of New York and New Jersey generally did not have documentation to justify the … controls to ensure special items (such as implants, drugs, and blood) that are not covered by the standard fee …
https://www.osc.ny.gov/press/releases/2014/01/comptroller-dinapoli-releases-state-auditsUlster County Community College - Retiree Health Insurance and Payroll (2018M-123)
… Audit Objective Determine whether College officials (officials) established adequate internal controls over: The retiree health insurance contribution billing process. The payroll … Establish adequate segregation of duties within the College’s payroll process. Ensure that payroll registers are …
https://www.osc.ny.gov/local-government/audits/community-college/2018/10/26/ulster-county-community-college-retiree-health-insurance-and-payrollMedicaid – Federal Funding and New York
… NYS Department of Health; OSC analysis FIGURE 2 – Medicaid Revenue by Department FY 2026 Preliminary Budget (in … for Children’s Svcs 5.4 5.4 Dept for the Aging 4.1 3.7 Total $ 381.2 $ 375.4 Sources: NYC Office of Management and … is about $30 billion, not including supplemental Medicaid payments. The City reimburses the State for its portion of …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/medicaid-nycIV.3.B Miscellaneous Receipts – IV. Accounting Codes - Uses and Descriptions
… OTB Tickets Uncashed winning tickets. 31023 Unclaimed Lottery Tickets Uncashed winning tickets. 31041 Uncashed … and cable companies. 31121 Medical Care – Statewide Hospital Patient Services 1% of each general hospital's gross revenue received for inpatient hospital …
https://www.osc.ny.gov/state-agencies/gfo/chapter-iv/iv3b-miscellaneous-receiptsVillage of West Haverstraw - Accrued Leave and Benefits (2019M-143)
… whether eligible Village employees received and used leave accruals in accordance with Village policies, and … The Treasurer did not maintain separate records on leave accruals earned and used for administrative employees, or the amount of sick leave accrued and to be carried over to the next fiscal year. …
https://www.osc.ny.gov/local-government/audits/village/2019/09/06/village-west-haverstraw-accrued-leave-and-benefits-2019m-143State Comptroller DiNapoli Releases Audits
… announced today the following audits have been issued. Department of Civil Service: New York State Health Insurance … Program – Cost Saving Opportunities on Payments of Medicare Part C Claims (2020-S-65) New York’s current … the state could save over $122 million annually. State Education Department (SED): Review of Advance Contract …
https://www.osc.ny.gov/press/releases/2021/10/state-comptroller-dinapoli-releases-auditsDiNapoli: Audit Shows Health Department Overpaid Certain Medicaid Managed Care Premiums
… guidance that allowed MCOs to misreport non-allowable marketing expenses, contrary to the intent of a policy change … 2009, DOH has contracted with Mercer Health and Benefits, LLC to provide actuarial services and guidance in setting all … expenses, and assess whether planned cost savings can be achieved under current MCO reporting practices; Revise …
https://www.osc.ny.gov/press/releases/2016/10/dinapoli-audit-shows-health-department-overpaid-certain-medicaid-managed-care-premiumsCost-Saving Ideas: Overtime Planning and Management
… including pension benefits, are large expenses for New York's local governments and school districts. These costs … 30 percent of wages paid to highway employees in New York State are for overtime. A written plan to guide the …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-overtime-planning-and-managementIncorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)
… initial audit report, Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under … The Empire Plan is the primary health benefits plan for NYSHIP, covering over 1 million members. Civil Service … CVS Caremark to administer the prescription drug program for the Empire Plan. This program includes a Commercial Plan …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-underDiNapoli: Former Village of Chatham Clerk-Treasurer Pleads Guilty to Defrauding Village
… District Attorney Paul Czajka, and the New York State Police announced that Barbara Henry, the Village of Chatham’s … clerk-treasurer, has pleaded guilty to attempted official misconduct for unlawfully waiving her own health insurance … thank District Attorney Paul Czajka and the New York State Police for their partnership in safeguarding public funds.” …
https://www.osc.ny.gov/press/releases/2021/09/dinapoli-former-village-chatham-clerk-treasurer-pleads-guilty-defrauding-villageMainstream Managed Care Organizations – Administrative Costs Used in Premium Rate Setting (Follow-Up)
… Purpose To determine the extent of implementation of the seven … Managed Care Organizations – Administrative Costs Used in Premium Rate Setting ( 2014-S-55 ). Background The Department … Reports (MMCORs). The Department issues MMCOR instructions to guide MCOs on how to report administrative expenses. We …
https://www.osc.ny.gov/state-agencies/audits/2018/12/27/mainstream-managed-care-organizations-administrative-costs-used-premium-rate-setting-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… range of services including, but not limited to, hospital services, office visits, home care, medical … rate schedules for the payment of inpatient and outpatient hospital services. Empire’s hospital contracts also allow certain special items, such as …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsTown of Callicoon – Cash Receipts and Disbursements (2013M-16)
… Supervisor and four Board members. The Town’s 2012 adopted budget totaled approximately $2.3 million. Key Findings The … the Board had not defined the rate or percentage of health insurance premiums that retirees must pay for their continuing health insurance coverage, we were unable to determine whether the …
https://www.osc.ny.gov/local-government/audits/town/2013/06/07/town-callicoon-cash-receipts-and-disbursements-2013m-16State Comptroller DiNapoli Releases Audits
… in a trend of increasing annual deficits. Department of Health (DOH): Inappropriate Payments Related to Procedure … the inappropriate payments identified. Department of Health (DOH): Medicaid Claims Processing Activity April 1, … of Event Recorder Units (2018-S-19) Auditors found train car inspections were not always done on time. They determined …
https://www.osc.ny.gov/press/releases/2019/09/state-comptroller-dinapoli-releases-auditsDiNapoli Announces State Contract And Payment Actions For October 2015
… New York State Police $154,200 lease with SG Chappaqua B LLC for State Police barracks at New Castle. State University … $255,000 to the New York Wine & Grape Foundation for marketing promotion. Department of Civil Service $90.6 … Department of Economic Development $43,000 to Travel Link Marketing Co. LTD for tourism representation services in …
https://www.osc.ny.gov/press/releases/2015/11/dinapoli-announces-state-contract-and-payment-actions-october-2015