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Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… to matters addressing the Doctor’s prescribing activity for the period January 1, 2013 through June 30, 2016. Background The Department is responsible for administering New York State’s Medicaid program. Medicaid … disadvantaged and/or have special health care needs. For the State fiscal year ended March 31, 2016, New York’s …
https://www.osc.ny.gov/state-agencies/audits/2017/06/27/medicaid-program-medicaid-payments-pharmacy-claims-joia-pharmacy-and-related-prescriberMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… durable medical equipment, and laboratory services) on behalf of 10,906 Medicaid recipients who were diagnosed … dialysis treatments, and qualified for Medicare based on his parent’s work credits. Had the child been enrolled in … saved about $1.5 million over a four-year period. Based on our analysis of the $146 million, we estimated the …
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
… by State regulations. Our audit scope covers the period from January 1, 2015 through December 16, 2016. Background …
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
… program, and sufficiently documented pursuant to the State Education Department’s (SED) Reimbursable Cost Manual …
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
… Purpose To determine whether the costs reported by Brookville Center for Children’s Services, Inc. (Brookville) on its Consolidated Fiscal Reports (CFRs) were …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… determined that Davis Ethical likely fabricated nearly all of the improper claims. Davis Ethical processed many of … work with the Nassau County District Attorney and the New York State Department of Financial Services. On December …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacy-followDiNapoli 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 appointment of Anastasia Titarchuk as Interim Chief Investment Officer of … and alternative instruments. Find out how your government money is spent at Open Book New York . Track municipal …
https://www.osc.ny.gov/press/releases/2018/07/dinapoli-announces-interim-cio-new-york-state-common-retirement-fundChanges in Federal Policies Pose Significant Risks for New York City's Budget
… Projected budget gaps for New York City in the coming years appear manageable, but tax changes and … by State Comptroller Thomas P. DiNapoli. "Major shifts in federal fiscal policies constitute the greatest risk to … may lie ahead, depending on the effects of what happens in Washington." The November update to the city’s four-year …
https://www.osc.ny.gov/press/releases/2017/12/changes-federal-policies-pose-significant-risks-new-york-citys-budgetMedicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
… manner, in some cases taking more than six months to enter new enrollee eligibility data. Key Recommendations Review the …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careDiNapoli: Contractor Sentenced in Federal Court for Defrauding State of Over $360,000
… a complaint online at [email protected] , or by mailing a complaint to: Office of the State …
https://www.osc.ny.gov/press/releases/2014/09/dinapoli-contractor-sentenced-federal-court-defrauding-state-over-360000United HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… provided to Empire Plan members. United contracts with in-network participating providers who agree to accept … co-insurance) when they use non-participating providers. In accordance with the Empire Plan’s requirements, when … waives) the member’s out-of-pocket costs, it will result in United making an excessive payment on the claim. Our audit …
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
… tax forms, but too much of this money remains unused when it should be fighting cancer, helping veterans, or … Remembrance and Cemetery Maintenance and Operation, and Teen Health Education. The more than $15 million sitting …
https://www.osc.ny.gov/press/releases/2015/04/dinapoli-proposal-would-provide-more-accountability-personal-income-tax-check-fundsImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… in our initial audit report, Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by … to as dual-eligibles), Medicare is the primary payer for Medicare-covered hospice services, while Medicaid is the … to delivering services, hospice providers are responsible for developing a comprehensive plan of care and coordinating …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followDiNapoli: Livingston County Woman Arrested for Theft of Deceased Mother's Pension Payments
… $34,500 of her mother’s public pension payments after she died in January of 2020. “Ms. Chatley allegedly concealed her … and country to protect the New York State pension system from fraud.” “We are thankful for the diligent and thorough …
https://www.osc.ny.gov/press/releases/2024/01/dinapoli-livingston-county-woman-arrested-theft-deceased-mothers-pension-paymentsDiNapoli: State Needs to Help Addiction Support Providers Better Prepare for Emergencies
… treatment programs may not be adequately prepared in an emergency to prevent gaps in care, which could … OASAS has not tried to improve the accuracy of its wait list data for certified substance use disorder programs. As a … needed information to OASAS for its central waiting list directory or are sending inaccurate information. If …
https://www.osc.ny.gov/press/releases/2023/11/dinapoli-state-needs-help-addiction-support-providers-better-prepare-emergenciesDiNapoli: Village of Candor Mayor Arrested for Allegedly Stealing From the Village
… as either “ATM Withdrawal” or “Mayor’s Discretionary.” The discovery was referred to the Office of the State …
https://www.osc.ny.gov/press/releases/2024/07/dinapoli-village-candor-mayor-arrested-allegedly-stealing-villageMedicaid Program – Improper Payments for Ancillary Services Provided During Hospital Inpatient Admissions
… claims for ancillary services in accordance with Medicaid reimbursement policies. The audit covers the period April 1, … claims in accordance with the Department's Medicaid reimbursement policies. Some edits check various Department … reported to Department officials for review. Medicaid reimbursement rates for inpatient hospital claims include the …
https://www.osc.ny.gov/state-agencies/audits/2014/04/03/medicaid-program-improper-payments-ancillary-services-provided-during-hospital-inpatientDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… $69 million from 2016 to 2018, which includes $17 million in savings for counties and New York City. "New Yorkers … uncertainty over Medicaid under the new administration in Washington, states need to take every initiative to defray … 30.6 percent; and localities funded the rest. As noted in the audit, many of the state's Medicaid recipients are …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-state-missing-out-millions-medicare-payments-kidney-patientsState Pension Fund Adds $30 Million for Investments in New York Companies
… $30 million to Primary Venture Partners to invest in state-based companies, New York State Comptroller Thomas … The commitment will be made through the pension fund’s In-State Private Equity Investment Program, designed to make profitable investments in companies located in New York state. This is the state …
https://www.osc.ny.gov/press/releases/2015/03/state-pension-fund-adds-30-million-investments-new-york-companies