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Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… well as the rules and policies set forth by the Department of Health (Department) and the State Education Department. … 2008 through December 31, 2012. Note : During the course of the audit, the audit fieldwork was temporarily suspended … with a review by other external oversight authorities of some of the matters addressed in this report. Subsequent …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/medicaid-program-medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriberPayments 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 … determined that Davis Ethical likely fabricated nearly all of the improper claims. Davis Ethical processed many of the …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… disadvantaged and/or have special health care needs. In general, the Medicaid program pays medical providers … 29,289 fee-for-service pharmacy claims totaling $978,251 on behalf of 18,010 recipients whose pharmacy benefits were … manner, in some cases taking more than six months to enter new enrollee eligibility data. Key Recommendations Review the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careDiNapoli Statement on Greenville Arrest for Alleged Theft of Taxpayer Funded Resources
… released the following statement regarding the arrest of Terry Williams for alleged theft of fuel from the Town of Greenville Highway Department. The theft was discovered …
https://www.osc.ny.gov/press/releases/2018/07/dinapoli-statement-greenville-arrest-alleged-theft-taxpayer-funded-resourcesDiNapoli 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 current CIO Vicki Fuller is retiring the week of July 30 after six years of service. "My thanks go to Vicki …
https://www.osc.ny.gov/press/releases/2018/07/dinapoli-announces-interim-cio-new-york-state-common-retirement-fundSpecial Plan for Suffolk County Park Police Officers (Sections 89-r and 603(n))
… to Top) … Information for members about Special Plan for Suffolk County Park Police Officers Sections 89r and 603n …
https://www.osc.ny.gov/retirement/publications/special-plan-suffolk-county-park-police-officers-sections-89-r-and-603nMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… renal disease who were eligible for, but not enrolled in, Medicare. The audit covered the period January 1, 2010 … with ESRD. Medicaid recipients with ESRD are eligible for Medicare coverage if they receive regular dialysis treatments … When Medicaid recipients with ESRD are also enrolled in Medicare, Medicare becomes the primary insurer (payer) and …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-diseaseOversight of Hotels and Motels Used for Homeless and Mixed-Use Temporary Residency
… Since our 2016 report, OTDA has established a standard checklist that SSDs can use to guide required six-month … full understanding of the goals of the overall inspection checklist as well as the inspection function. Establish a …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/oversight-hotels-and-motels-used-homeless-and-mixed-use-temporary-residencyLifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… to children with disabilities who are between the ages of three and five years. During the 2014-15 school year, … served about 52 students. The New York City Department of Education (DoE) refers students to Lifeline and pays for … by SED. The DoE is reimbursed by SED for a portion of its payments to Lifeline. For the three fiscal years ended …
https://www.osc.ny.gov/state-agencies/audits/2017/10/12/lifeline-center-child-development-inc-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… services to children with disabilities between the ages of three and five years. During the 2013-14 school year, … by SED. Counties are reimbursed by SED for a portion of their payments to Brookville. For the three fiscal years … to help ensure their compliance with the provisions of the Manual. To Brookville: Ensure that all costs reported …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualDiNapoli: Contractor Sentenced in Federal Court for Defrauding State of Over $360,000
… to federal fraud charges earlier this year, as a result of a joint investigation by New York State Comptroller Thomas … to a year and one day in prison and ordered to pay a total of $721,112 in restitution and criminal forfeiture. “Joseph … for cancer and used the money to fund his lavish lifestyle of world traveling and gambling,” DiNapoli said. “This …
https://www.osc.ny.gov/press/releases/2014/09/dinapoli-contractor-sentenced-federal-court-defrauding-state-over-360000Special 25-Year Plan for Institutional Safety Officers (Sections 89-t and 604(q))
… (Return to Top) (Return to Top) VO1873 (Rev. 7/11) © 2011, New York State and Local Retirement System (Return to Top) … …
https://www.osc.ny.gov/retirement/publications/special-25-year-plan-institutional-safety-officers-sections-89-t-and-604qUnited HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… Center, LLC waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from … out-of-pocket costs. To limit the negative financial impact to the Empire Plan, United reduced its payments on …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… Purpose To determine whether the Department of Health paid pharmacy providers for controlled substances in … identified two MCOs that, similar to the Department, do not have system edits to prevent the payment of pharmacy …
https://www.osc.ny.gov/state-agencies/audits/2015/02/06/medicaid-program-improper-payments-controlled-substances-exceed-allowed-dispensing-limitsUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… Purpose To determine whether Orthopedic Associates of Long Island, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made … primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital care to outpatient …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandDiNapoli Proposal Would Provide More Accountability for Personal Income Tax Check-Off Funds
… manner.” Currently, there are ten causes that New Yorkers can support through personal income tax check-offs, including … and exploited children efforts; veterans’ causes; and disease research. Taxpayers will be able to contribute to a … starting with the 2015 tax year. A 2014 State Comptroller’s report found that over the previous five years, receipts …
https://www.osc.ny.gov/press/releases/2015/04/dinapoli-proposal-would-provide-more-accountability-personal-income-tax-check-fundsDiNapoli Announces Nominee for the Commission on Ethics and Lobbying in Government
… Thomas P. DiNapoli today announced his nomination of Nancy G. Groenwegen to the Commission on Ethics and … and accountability. Nancy’s character, knowledge and depth of experience will help New York meet those challenges and … Groenwegen served as the commissioner and president of the New York Civil Service Commission and as an assistant …
https://www.osc.ny.gov/press/releases/2022/07/dinapoli-announces-nominee-commission-ethics-and-lobbying-governmentDiNapoli: Former Village of Sherman Treasurer Arrested for Alleged Theft of $20,000
… neighbors by pocketing tax payments to pay her personal expenses,” DiNapoli said. “I thank District Attorney Schmidt …
https://www.osc.ny.gov/press/releases/2022/08/dinapoli-former-village-sherman-treasurer-arrested-alleged-theft-20000DiNapoli: Orange County Resident Arrested for Stealing Her Late Mother’s Pension Benefits
… New York State Police today announced that Valerie White, of Middletown, was arrested and charged with grand larceny in … degree (Class C Felony) for allegedly stealing $51,532.64 of her late mother’s pension payments. “Ms. White thought she … face consequences for their criminal actions.” “The theft of public funds is simply inexcusable. I applaud Comptroller …
https://www.osc.ny.gov/press/releases/2021/06/dinapoli-orange-county-resident-arrested-stealing-her-late-mothers-pension-benefitsImproper Fee-for-Service Payments for Services Covered by Managed Long-Term Care Plans (Follow-Up)
… Covered by Managed Long-Term Care Plans (Report 2018-S-65 ). About the Program The State’s Medicaid program offers …
https://www.osc.ny.gov/state-agencies/audits/2021/08/31/improper-fee-service-payments-services-covered-managed-long-term-care-plans-follow