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

… Medicaid Costs for Recipients With End Stage Renal Disease ( 2015-S-14 ) Department of Health: Medicaid Claims …

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

… health insurance coverage. The audit covered the period January 1, 2012 to September 1, 2017. Background The Medicaid … of enrollees who also had concurrent comprehensive TPHI: $26.9 million (about 73,000 premiums) can be recovered because …

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

… 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 … on January 8, 2015. Our objective was to determine whether United improperly paid for medical services designated with …

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

… New York State Comptroller Thomas P. DiNapoli released the … following an investigation by DiNapoli’s office and the New York State Police. "Mr. Williams allegedly abused his … DiNapoli said. "Thanks to my ongoing partnership with the New York State Police, Mr. Williams' alleged acts have been …

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

… 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 …

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

… calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the …

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

… and Civil Service reimburses United for the payments it makes. United contracts with in-network (participating) …

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

… the costs reported by Children’s Unit for Treatment and Evaluation (CUTE) on its Consolidated Fiscal Reports … (CFR) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) … on CUTE’s CFR for the fiscal year ended June 30, 2016 and certain costs reported on its CFRs for the two fiscal …

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

… Youth and Families, Inc. (Educators) appropriately used State funds received from the State Education Department (SED) and the Office of Children … of expenditures claimed. Of this amount, $687,360 was paid by SED and $196,170 was paid by OCFS. The $196,170 of …

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

… A former state contractor who pleaded guilty to federal fraud charges earlier this year, as a result of a … the Southern District Preet Bharara, was sentenced today to a year and one day in prison and ordered to pay a total of $721,112 in restitution and criminal …

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

… $14,600 in disbursements. Key Findings Company bylaws do not include specific procedures regarding the support for … financial system, without canceled check images, it could not be verified. Key Recommendations Revise bylaws to include …

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

… Alcoholism and Substance Abuse Services must recoup this money, which should have been used for cost-effective …

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

… determined it should have reported 769, including two sex offenses that involved inappropriate sexual contact and …

Lifeline 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 …

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

… fiscal years ended June 30, 2013. Background Brookville is a Nassau County-based not-for-profit organization authorized … established by SED. Counties are reimbursed by SED for a portion of their payments to Brookville. For the three …

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

… services that were erroneously billed as inpatient claims. The audit covered the period from January 2018 through March 2022. About the Program The State’s Medicaid program is administered by the Department of … The Medicaid program reimburses hospitals for inpatient and outpatient services. A recipient’s status in a hospital – …

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

… was limited. Neither the Department nor OMIG reconciled or monitored Gainwell’s recoveries by comparing claims …

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

… The audit found that, under the management of Homes and Community Renewal (HCR) and its local program … the Coronavirus Aid, Relief, and Economic Security Act of 2020 (CARES Act) with a HUD-HCR funding agreement through … HCR must expend at least 80% of the funds by September 23, 2023. DiNapoli’s audit found HCR needs to improve its …