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State Comptroller DiNapoli Statement on Arrest of Muge Ma for COVID-Related Scam
… equipment in order to line his own pocket. Using a public health crisis to commit fraud is reprehensible,” State …
https://www.osc.ny.gov/press/releases/2020/05/state-comptroller-dinapoli-statement-arrest-muge-ma-covid-related-scamDiNapoli: Former Clerk Treasurer for the Village of Speculator Charged With Larceny
… Former Speculator village clerk-treasurer Bonnie Page was charged with grand larceny and corrupting the government for allegedly scamming the village out of $25,988 for health insurance benefits for her … Former Speculator village clerktreasurer Bonnie Page was charged with grand …
https://www.osc.ny.gov/press/releases/2020/02/dinapoli-former-clerk-treasurer-village-speculator-charged-larcenyDiNapoli: SED Makes Progress on Implementation of Dignity for All Students Act
… requirements on the “ Responding to Incidents” sample form it made available during an August 2018 training and on …
https://www.osc.ny.gov/press/releases/2019/11/dinapoli-sed-makes-progress-implementation-dignity-all-students-actRFP#0010 – Financial Organization (Trustee) Services for Length of Service Award Programs
… available via the links below. The solicitation, and other information as it becomes available, is available … solicitation has been posted in Adobe Acrobat PDF format and may be opened with the free Acrobat reader, available …
https://www.osc.ny.gov/procurement/rfp0010Administration of the CityFHEPS Program for Department of Homeless Services Shelter Residents
… thereby assisting Department of Homeless Services shelter residents in securing permanent housing. The audit … were approved for CityFHEPS and subsequently exited the shelter into permanent housing. In one case, a client had to … are identified and receive Shopping Letters, and that shelter exits are recorded and reported accurately. DSS does …
https://www.osc.ny.gov/state-agencies/audits/2024/10/30/administration-cityfheps-program-department-homeless-services-shelter-residentsNew York Institute for Special Education – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by the New York Institute for Special Education (Institute) on its Consolidated Fiscal Reports (CFRs) were … The audit focused primarily on expenses claimed on the Institute’s CFR for the fiscal year ended June 30, 2020 and …
https://www.osc.ny.gov/state-agencies/audits/2024/12/18/new-york-institute-special-education-compliance-reimbursable-cost-manualAdministration of the CityFHEPS Program for Department of Social Services Homebase Clients
… the homelessness crisis. According to the Coalition for the Homeless, the court-appointed independent monitor of … providers. As a result, program applicants were exposed to apartment units with immediately hazardous violations despite … we found that DSS staff approved a client to move into an apartment with significant habitability issues, despite …
https://www.osc.ny.gov/state-agencies/audits/2026/01/07/administration-cityfheps-program-department-social-services-homebase-clientsMedicaid Program – Medicaid Payments for Early Refills of Prescription Drugs and Supplies
… amount has been used, or up to a 10-day supply of medication is remaining of the cumulative amount that has … apply). To prevent stockpiling and potential misuse of medication, DOH uses system controls known as edits to deny …
https://www.osc.ny.gov/state-agencies/audits/2026/03/20/medicaid-program-medicaid-payments-early-refills-prescription-drugs-and-suppliesUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… our audit report, UnitedHealthcare: Improper Payments for Medical Services Designated By Modifier Code 59 (Report … 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 procedure codes …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… Health (Department) made Medicaid mainstream managed care premium payments on behalf of individuals who had … Medicaid pays managed care organizations (MCOs) a monthly premium for each enrolled Medicaid recipient, and the MCOs … paid about $1.28 billion in Medicaid managed care premium payments on behalf of enrollees who also had …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… To determine whether UnitedHealthcare overpaid for out-of-network anesthesia services provided at Ambulatory Surgery … Program (NYSHIP), administered by the State Department of Civil Service (Civil Service), provides health insurance … The Empire Plan provides its members with four types of health insurance coverage: medical/surgical, hospital, …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatorySchool for Language and Communication Development – Compliance With the Reimbursable Cost Manual
… School for Language and Communication Development (SLCD) on its Consolidated Fiscal Reports (CFR) were properly … Cost Manual (RCM). The audit covered the expenses reported on SLCD’s CFR for the fiscal year ended June 30, 2015, and certain expenses reported on SLCD’s CFRs for the two fiscal years ended June 30, 2014. …
https://www.osc.ny.gov/state-agencies/audits/2018/04/16/school-language-and-communication-development-compliance-reimbursable-cost-manualBrookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual
… services to children with disabilities between the ages of three and five years. During the 2013-14 school year, … by SED. Counties are reimbursed by SED for a portion of their payments to Brookville. For the three fiscal years … to help ensure their compliance with the provisions of the Manual. To Brookville: Ensure that all costs reported …
https://www.osc.ny.gov/state-agencies/audits/2017/10/04/brookville-center-childrens-services-inc-compliance-reimbursable-cost-manualLifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… to children with disabilities who are between the ages of three and five years. During the 2014-15 school year, … served about 52 students. The New York City Department of Education (DoE) refers students to Lifeline and pays for … by SED. The DoE is reimbursed by SED for a portion of its payments to Lifeline. For the three fiscal years ended …
https://www.osc.ny.gov/state-agencies/audits/2017/10/12/lifeline-center-child-development-inc-compliance-reimbursable-cost-manualUnited HealthCare – Overpayments for Services Provided by Orthopedic Associates of Long Island
… Orthopedic Associates of Long Island, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the … school district employees and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-orthopedic-associates-long-islandMedicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
… pharmacies can dispense when prescriptions are ordered via telephone or fax, due to the inherent risk of drugs ordered … allowed by the Act. In one instance, a pharmacy filled two telephone orders for alprazolam (a drug used to treat … Each order was filled for a 30-day supply even though telephone orders for this drug are limited to a five-day …
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 Eastern Orange Ambulatory Surgery Center
… the $1,480 due from the member. Eastern Orange wrote off all charges in excess of United’s payment from the member’s …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Background Our initial audit report, which was issued on August 13, 2013, determined that, for the period January 1, …
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
… Medicaid made improper fee-for-service claim payments for pharmacy services covered by recipients’ managed care plans. … provided to their enrollees. Prior to October 2011, pharmacy benefits were reimbursed through the fee-for-service … care coverage. However, beginning October 1, 2011, most pharmacy benefits were covered by managed care plans, and …
https://www.osc.ny.gov/state-agencies/audits/2015/01/05/medicaid-program-improper-fee-service-payments-pharmacy-services-covered-managed-careEducators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)
… recommendations included in our initial audit report, Educators for Children, Youth and Families, Inc. - Use of … which was issued on August 20, 2010, examined whether Educators for Children, Youth and Families, Inc. (Educators) … Department/Office of Children and Family Services: Educators for Children, Youth and Families, Inc. - Use of …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/educators-children-youth-and-families-inc-use-contract-funds-follow