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

… from June 1, 2012 through May 31, 2017. Background Many of the State’s Medicaid recipients are also eligible for … supplementary medical insurance coverage for a range of outpatient medical services, physician services, and … the claims bypass the payment controls enforced by the crossover system. Key Findings Auditors identified up …

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

… through New York State of Health (NYSOH), New York’s online health insurance marketplace, and the remainder were …

UnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)

… in our audit report, UnitedHealthcare: Improper Payments for Medical Services Designated By Modifier Code 59 (Report … The Empire Plan is the primary health benefits plan for NYSHIP. The New York State Department of Civil Service … (United) to process and pay medical and surgical claims for services provided to Empire Plan members. United’s …

DiNapoli Statement on Greenville Arrest for Alleged Theft of Taxpayer Funded Resources

… and paid for by taxpayers," DiNapoli said. "Thanks to my ongoing partnership with the New York State Police, Mr. …

DiNapoli Announces Interim CIO for the New York State Common Retirement Fund

… Investment Officer of the New York State Common Retirement Fund. The Fund’s current CIO Vicki Fuller is retiring the week of July …

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

… Purpose To determine whether the costs reported by the School for Language and Communication Development … for preschool special education services through rates set by SED. The reimbursement rates are based on financial … To SED: Review the disallowances identified by our audit and, if warranted, make the necessary …

UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers

… Purpose To determine whether UnitedHealthcare overpaid for … Surgery Centers that were contractually required to use in-network anesthesia providers. The audit covered the …

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 … (RCM). The audit covered expenses reported on CUTE’s CFR for the fiscal year ended June 30, 2016 and certain costs reported on its CFRs for the two fiscal years ended June 30, 2015. About the …

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

… included in our initial audit report, Educators for Children, Youth and Families, Inc. - Use of Contract … was issued on August 20, 2010, examined whether Educators for Children, Youth and Families, Inc. (Educators) … Children and Family Services (OCFS) under grant contracts for the period July 1, 2002 through June 4, 2008. New York …

DiNapoli: Contractor Sentenced in Federal Court for Defrauding State of Over $360,000

… State Comptroller Thomas P. DiNapoli and U.S. Attorney for the Southern District Preet Bharara, was sentenced today … Junkovic took taxpayer dollars meant to screen individuals for cancer and used the money to fund his lavish lifestyle of … the state. I commend U.S. Attorney Bharara and his staff for their work to bring Mr. Junkovic to justice, and I will …

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

… Fire Company is a volunteer organization that is located in, and provides fire protection services for, the Town of Union in Broome County. The Company’s Officers consist of four … fiscal year, the Company reported approximately $20,000 in revenues from foreign fire insurance, fundraising …

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

… revealed that millions of dollars were claimed and spent on ineligible costs. Officials from the Office of Alcoholism … 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 …

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

… year as well as details about the incidents. DiNapoli’s auditors reviewed incident records for seven schools outside of New York City for the 2011-12 school year, identifying a total of …

Lifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual

… by Lifeline Center for Child Development, Inc. (Lifeline) on its Consolidated Fiscal Reports (CFRs) were reasonable, … Claiming Manual (CFR Manual). The audit focused primarily on expenses claimed on Lifeline’s CFR for the fiscal year … students to Lifeline and pays for their services using rates established by SED. The DoE is reimbursed by SED for a …

Brookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual

… determine whether the costs reported by Brookville Center for Children’s Services, Inc. (Brookville) on its … The audit included expenses claimed on Brookville’s CFR for the fiscal year ended June 30, 2014, and certain expenses claimed on its CFRs for the two fiscal years ended June 30, 2013. Background …

Medicaid Program – Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims

… treatment and recovery. Generally, outpatient services are medical procedures that can be performed in the same day. … for calculating the reimbursement. Outpatient services are typically reimbursed using rate codes, and each service … could trigger a separate payment. Outpatient services are generally less expensive than inpatient treatments …

Medicaid Program – Improper Fee-for-Service Pharmacy Payments for Recipients With Third-Party Health Insurance

… Program The Department of Health (Department) administers New York’s Medicaid program. Under the fee-for-service (FFS) …

DiNapoli: State is Slow in Disbursing Some Federal Relief Funds for Housing

… New York has been slow when it comes to using some federal relief funds earmarked to alleviate the state’s affordable … in allocating it to specific housing projects or housing relief programs could result in funds being lost. “The state … work more efficiently to ensure the unprecedented federal relief funds help New Yorkers in need and are not lost …