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UnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services
… for higher-paying Evaluation and Management services than what were actually performed. The audit covered the period … district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering a … each category, there are either three or five levels of care that providers bill. The amount of United’s …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesThe Economic Impact of the Great Outdoors
Outdoor recreation in New York provided $21.1 billion in economic activity in 2020 and supported over 241,000 jobs. While New York ranks fourth in the nation on GDP generated by outdoor recreation, outdoor recreation represents a more significant part of the economy in nearly every other state.
https://www.osc.ny.gov/files/reports/pdf/economic-impact-great-outdoors.pdfLocal Sales Taxes Surge 49.2 Percent in April-June 2021 Over Same Quarter in 2020: Statewide Collections Strong Even Compared to Pre-Pandemic Period
Local sales tax collections in New York State grew by 49.2 percent, or just over $1.6 billion, in the second quarter of 2021 compared to the same period last year, a dramatic increase from last year’s weak collections during the first wave of the COVID-19 pandemic.
https://www.osc.ny.gov/files/local-government/publications/pdf/local-sales-taxes-surge-in-april-june-2021.pdfMedicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
… Purpose To determine whether mainstream managed care organizations … (MCOs) are submitting accurate administrative costs to the Department of Health (Department) and whether the … To determine whether mainstream managed care organizations … MCOs are submitting accurate administrative costs to the Department of Health Department and whet …
https://www.osc.ny.gov/state-agencies/audits/2016/10/13/medicaid-program-mainstream-managed-care-organizations-administrative-costs-used-premiumSelected Aspects of Collecting Outstanding Amounts Due for Parking Violations
… 1, 2019, the outstanding balances due from New York State respondents (outside of NYC) totaled about $67.6 … outside of New York State, the address information DOF had on file differed from the Department of Motor Vehicles … for vehicles registered in New York State but with out-of-state addresses that have not been referred to the NYC …
https://www.osc.ny.gov/state-agencies/audits/2021/03/23/selected-aspects-collecting-outstanding-amounts-due-parking-violationsComptroller DiNapoli and Attorney General James Announce the Arrest and Indictment of Mount Vernon Corporation Counsel in $365,000 Corruption Scheme
… City of Mount Vernon Corporation Counsel Lawrence Porcari for abusing his position as a public official by engaging in … Government and four counts of Offering a False Instrument for Filing in the First Degree, all class E felonies. … of Mount Vernon Board of Water Supply to pay law firms for the personal defense of Mount Vernon Mayor Richard Thomas …
https://www.osc.ny.gov/press/releases/2019/05/comptroller-dinapoli-and-attorney-general-james-announce-arrest-and-indictment-mount-vernonHomeowners Association, Inc.
… $20,000 granted under contract TM09M10 with the New York State Office of Children and Family Services (OCFS) in … evidence to demonstrate it used the items purchased with State monies for purposes consistent with the contract. … minutes. We did not find any Homeowners related documents on these devises, but we found evidence of personal use, …
https://www.osc.ny.gov/state-agencies/audits/2013/12/10/homeowners-association-incSelected Payments for Special Items Made to St. Francis Hospital of Poughkeepsie from January 1, 2011 through March 31, 2011
… district employees and their dependents. The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. … in accordance with agreements they negotiate with member hospitals, including St. Francis. Empire’s payments to St. … to acquire them. Key Finding We reviewed one claim payment to St. Francis for special items and determined …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-francis-hospital-poughkeepsie-january-1-2011College at Cortland – Selected Employee Travel Expenses
… Purpose To determine whether the use of travel monies by selected government employees complied with rules and regulations and is free from fraud, waste, and abuse. The audit covers the … initiative to determine whether the use of travel money by selected government employees was appropriate, we audited …
https://www.osc.ny.gov/state-agencies/audits/2013/02/13/college-cortland-selected-employee-travel-expensesXI.18.A Executive Law Article 15-A- Participation by Minority Group Members and Women with Respect to State Contracts – XI. Procurement and Contract Management
… State Contracts” requires an agency to post on its website contractor utilization plans and any waivers of compliance …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xi/xi18a-executive-law-article-15-participation-minority-group-members-and-women-respect-stateXIV.8 Controls to Prevent Prohibited Transactions Using Sole Custody Funds – XIV. Special Procedures
… Financial System (SFS), vendors managed through the SFS Vendor File go through a Specially Designated Nationals validation as part of the New York State Vendor Registration process. However, Business Units who make … sole custody funds or through the use of a Single payment vendor ID within SFS must have proper controls in place to …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xiv/xiv8-controls-prevent-prohibited-transactions-using-sole-custody-fundsCost-Saving Ideas: School District Auditing – External Auditor
… required financial statement audit and renders an opinion on whether the financial statements are in accordance with … (PA) registered and licensed to practice in New York State; have or develop expertise in district financial … Guidance for School Districts [pdf]," - Office of the State Comptroller "Sample Request for Proposals (RFP) for …
https://www.osc.ny.gov/local-government/publications/cost-saving-ideas-school-district-auditing-external-auditorOversight of School Fire Safety Compliance (Follow-Up)
… of implementation of the four recommendations included in our original report, Oversight of School Fire Safety Compliance ( 2015-S-86 ). Background The State … compliance with fire safety provisions established in the State Education Law, the State Uniform Fire Prevention …
https://www.osc.ny.gov/state-agencies/audits/2017/11/28/oversight-school-fire-safety-compliance-followXVI.4.B Tax Revenues – XVI. Financial Reporting
… transactions: The State imposes the tax on the person or entity that acquires the income, goods or services The State … year were not sufficient to meet the tax liability of the entity. Due dates will vary depending on the fiscal year of … and Utilities Tax Bank Tax Insurance Tax Pass-Through Entity Tax Petroleum Business Taxes The pass-through entity …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xvi/xvi4b-tax-revenuesTuition Assistance Program – Metropolitan Learning Institute
… Rules and Regulations when certifying students for State-funded Tuition Assistance program (TAP) awards and other State financial aid. Background TAP is an entitlement … TAP awards totaling almost $8.7 million that were paid on behalf of 1,890 students. At the time of our audit, …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/tuition-assistance-program-metropolitan-learning-instituteUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… At the time of our follow-up review, William Davis made full restitution of $231,919 to the State, of which $137,459 …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyAccounts Receivable Collection and Reporting
… experienced one of the largest increases in third-party billing accounts receivable balances of any State public … in October 2011 by the Public Service Commission for utility charges associated with its newly enacted Energy …
https://www.osc.ny.gov/state-agencies/audits/2015/08/05/accounts-receivable-collection-and-reportingSelected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Empire BlueCross and BlueShield)
… from July through December 2012. Background The New York State Health Insurance Program (NYSHIP) provides health coverage to active and retired State, participating local government and school district … Payments for hospital services are generally based on standard fee schedules that are negotiated between Empire …
https://www.osc.ny.gov/state-agencies/audits/2014/01/16/selected-payments-special-items-period-july-1-2012-through-december-31-2012-empireSchool Tax Relief (STAR) Program (2012-MS-6)
… Purpose of Audit The purpose of our audit was to review local assessors’ administration of the STAR Program … and makes up the difference by increasing State aid to school districts. The State’s costs for underwriting this … the program’s inception, from $582 million in 1998-99 to $3.2 billion in 2010-11. Key Findings Local assessors have …
https://www.osc.ny.gov/local-government/audits/statewide-audit/2013/02/28/school-tax-relief-star-program-2012-ms-6Comptroller DiNapoli and Mayor Brown Return Over $100,000 in Unclaimed Funds to Buffalo Residents
… that $111,180 in unclaimed funds has been returned to Buffalo city residents since he partnered with Mayor Byron Brown on March 16 to urge people to claim their lost money. Over $88 million still remains … that $111180 in unclaimed funds has been returned to Buffalo city residents since he partnered with Mayor Byron …
https://www.osc.ny.gov/press/releases/2017/03/comptroller-dinapoli-and-mayor-brown-return-over-100000-unclaimed-funds-buffalo-residents