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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 … of age. CUTE is reimbursed for these services through rates set by SED. The reimbursement rates are based on financial information, including costs, …

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

… Purpose To determine the extent of implementation of the three … Key Finding We determined that SED and OCFS officials have made some progress in addressing the matters in our initial report. However, no funds have yet been recovered and all three recommendations have …

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 …

Monitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance (Follow-Up)

To determine the extent of implementation of the four recommendations included in our initial audit report Monitoring of NotforProfit Cemeteries for Fiscal Stability and Adequate Facility Maintenance 2016S79

Medicaid Program – Opioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program

… of Health has taken sufficient steps to safeguard Medicaid recipients who are receiving opioids while also in a Treatment Program for opioid use disorder. This audit covered the period … asked at least once during treatment to sign a consent form to coordinate care with the recipient’s opioid …

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

… of the State’s Medicaid recipients are also eligible for Medicare, the federal health insurance program for people age … programs are commonly referred to as “dual-eligible.” The Medicare program has multiple parts. Medicare Part B provides supplementary medical insurance …

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

… whether the costs reported by the School for Language and Communication Development (SLCD) on its Consolidated … (CFR) were properly calculated, adequately documented, and allowable under the State Education Department’s (SED) … The ineligible costs included: $28,271 in pension benefits for administrative employees that exceeded the …

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

… and retired State, participating local government, and school district employees, as well as their dependents. The Empire …

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

… the Department’s policy is to exclude Medicaid recipients from mainstream managed care when they have concurrent … are the same, the State can disenroll the recipients from managed care retroactively and recover premiums paid to … non-NYSOH-enrolled recipients with comprehensive TPHI from managed care. Review the managed care premiums we …

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

… Payments for Medical Services Designated By Modifier Code 59 (Report 2013-S-82 ). Background The New York State … that indicate the medical services performed. Modifier code 59 is used to indicate that a provider performed a …

Special 25-Year Plan for Institutional Safety Officers (Sections 89-t and 604(q))

… and Local Retirement System  (Return to Top) … Information for members about special 25 year retirement plan providing an alternative retirement benefit for institutional safety officers and safety and secur …

United HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center

… Purpose To determine whether Eastern Orange Ambulatory Surgery … Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare …

Medicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits

… Health paid pharmacy providers for controlled substances in compliance with the New York State Controlled Substances … or fax, due to the inherent risk of drugs ordered in this manner being diverted for inappropriate or … (MCOs) a monthly premium for each recipient enrolled in the MCO. The MCO then arranges for the provision of …

Special Plan for Suffolk County Park Police Officers (Sections 89-r and 603(n))

… and Local Retirement System (Return to Top) … Information for members about Special Plan for Suffolk County Park Police Officers Sections 89r and 603n …

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

… treatment provider was able to collect $3.9 million in ineligible payments due to the processing of invalid … $47.6 million contract with Phoenix House New York (PHNY) in 2009 to provide outpatient, inpatient, and residential … alcohol addiction treatment services at several facilities in the New York metropolitan area. The state’s contract with …

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 …

Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber

… oversight authorities of some of the matters addressed in this report. Subsequent to that review, we provided the … to matters addressing the Doctor’s prescribing activity for the period January 1, 2013 through June 30, 2016. Background The Department is responsible for …

Medicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease

… Purpose To determine whether the Department of Health took sufficient steps to control the Medicaid costs of recipients diagnosed with … and meet one of the following requirements: (1) have worked the required amount of time under Social …