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UnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… United’s payments to medical providers are based, in part, on procedure codes billed on claims that indicate the medical services performed. … or independent from another procedure that was performed on the same day for the same patient. Modifier 59 is used to …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followChanges in Federal Policies Pose Significant Risks for New York City's Budget
… agencies could be higher than planned; Proceeds from the sale of taxi medallions could fall short of expectations …
https://www.osc.ny.gov/press/releases/2017/12/changes-federal-policies-pose-significant-risks-new-york-citys-budgetMedicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… provides a wide range of medical services to those who are economically disadvantaged and/or have special health … claim costs totaled about $56 billion. Prescription drugs can be dispensed to Medicaid beneficiaries by licensed … wherein the drug and drug strength were different from what the physician prescribed; and Claims for unauthorized …
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)
… included in our initial audit report, Payments for Fraudulent and Improper Claims Submitted by Davis Ethical … which was issued on August 13, 2013, determined that, for the period January 1, 2008 through December 13, 2011, … fraudulent claims to Medicaid and received payments for those claims. We coordinated our audit and investigative …
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
… services to those who are economically disadvantaged and/or have special health care needs. In general, the … premium for every Medicaid recipient enrolled in the MCO, and the MCO arranges for the provision of services its … most pharmacy benefits were covered by managed care plans, and fee-for-service reimbursement was no longer appropriate …
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
… 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," …
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
… New York State Comptroller Thomas P. DiNapoli today announced his … We have worked diligently to grow the Fund’s investments on behalf of New York’s dedicated public workforce," Fuller … income, real estate and alternative instruments. Find out how your government money is spent at Open Book New York …
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))
… Top) (Return to Top) VO1855 (Rev. 6/12) © 2012, New York State and Local Retirement System (Return to Top) … …
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
… to control the Medicaid costs of recipients diagnosed with end stage renal disease who were eligible for, but not … on behalf of 10,906 Medicaid recipients who were diagnosed with ESRD. Medicaid recipients with ESRD are eligible for Medicare coverage if they receive …
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
… 16, 2016. Background According to a 2016 Department of Housing and Urban Development report, of the more than 86,000 … percent) are located in areas outside of New York City (NYC). Counties throughout the State utilize hotels and motels … are no formal shelters. Of the 57 counties outside of NYC, 24 (42 percent) do not have a dedicated shelter …
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 determine whether the costs reported by Lifeline Center for Child Development, Inc. (Lifeline) on its Consolidated … focused primarily on expenses claimed on Lifeline’s CFR for the fiscal year ended June 30, 2015, and included certain expenses claimed on Lifeline’s CFRs for the two fiscal years ended June 30, 2014. Background …
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
… 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 …
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
… earlier this year, as a result of a joint investigation by New York State Comptroller Thomas P. DiNapoli and U.S. … Preet Bharara, was sentenced today to a year and one day in prison and ordered to pay a total of $721,112 in … statewide to combat corruption in the misuse of public funds.” Junkovic, 49, of the Bronx, pleaded guilty in …
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) (Return to Top) VO1873 (Rev. 7/11) © 2011, New York State and Local Retirement System (Return to Top) … Information for members about special 25 year …
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
… January 1, 2011 through March 31, 2015. Background The New York State Health Insurance Program (NYSHIP) provides … provided to Empire Plan members. United contracts with in-network participating providers who agree to accept … overpayments. At the time of our audit fieldwork, United was negotiating with Eastern Orange to join the Empire Plan’s …
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
… drugs, to individuals who are economically disadvantaged and/or have special health care needs. The New York State … highly prone to abuse are limited to a five-day supply, and others that carry less risk are limited to a 30-day … paid pharmacy providers through the fee-for-service method and the managed care method. Under fee-for-service, Medicaid …
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
… The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient … process and pay medical claims from health care providers for services provided to Empire Plan members. United … pay a nominal co-payment to the participating provider for the services rendered. Members may also choose to receive …
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
… “New Yorkers have contributed more than $50 million for worthy causes through check-offs on their personal income … report found that over the previous five years, receipts for the funds reached $12 million, while expenditures were … 90 percent of this was in health-related dedicated funds – for research, detection and education for breast cancer and …
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
… today announced his nomination of Nancy G. Groenwegen to the Commission on Ethics and Lobbying in Government. Groenwegen previously served as counsel to the Comptroller from 2010 to 2019. “Nancy is well known for her integrity and …
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
… theft of more than $20,000 in cash paid by residents from 2012 to 2016 for village sewer, water and taxes, … Attorney Schmidt said. “The Village of Sherman, like many of our local municipalities here in Chautauqua County, is engaged in an every-day battle to service its residents with precious …
https://www.osc.ny.gov/press/releases/2022/08/dinapoli-former-village-sherman-treasurer-arrested-alleged-theft-20000