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Medicaid Program – Improper Managed Care Payments for Recipients With Duplicate Client Identification Numbers
… (MCOs) a monthly premium for each enrolled recipient and, in turn, the MCOs pay for services their members require. … referred to as “duplicate CINs”) during the time they are in receipt of benefits. Consistent with the Department’s … and enrollment data necessary to make appropriate claim payments. When an individual is assigned duplicate …
https://www.osc.ny.gov/state-agencies/audits/2019/07/29/medicaid-program-improper-managed-care-payments-recipients-duplicate-client-identificationNew York State Health Insurance Program – Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan
… and retired State, participating local government, and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/new-york-state-health-insurance-program-incorrect-payments-cvs-caremark-medicare-rx-drugState Comptroller DiNapoli Releases State Audits and Examinations
… should address to improve Centro’s information security program for cardholder data and to help ensure it meets PCI … Higher Education Services Corporation: Tuition Assistance Program, Fordham University (2016-T-2) Auditors determined …
https://www.osc.ny.gov/press/releases/2017/02/state-comptroller-dinapoli-releases-state-audits-and-examinationsMedicaid Program – Payments for Death-Related One-Day Inpatient Admissions
… Purpose To determine whether the Department of Health (Department) appropriately and effectively implemented and applied the new APR DRG-based hospital inpatient payment system for …
https://www.osc.ny.gov/state-agencies/audits/2013/08/15/medicaid-program-payments-death-related-one-day-inpatient-admissionsState Comptroller DiNapoli Releases Audits
New York State Comptroller Thomas P DiNapoli announced today the following audits and examinations have been issued
https://www.osc.ny.gov/press/releases/2019/01/state-comptroller-dinapoli-releases-auditsMedicaid Program – Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare
… About the Program Hospice is a coordinated program of home and/or inpatient care that treats terminally ill … Hospice programs provide palliative care, including nursing, physician, and counseling services; home health … Care (MLTC) plans, which serve people who require nursing home or long-term home health care. When a Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2020/12/28/medicaid-program-improper-medicaid-payments-individuals-receiving-hospice-services-coveredKidz Therapy Services, PLLC – Compliance With the Reimbursable Cost Manual
… the appropriate adjustments to Kidz Therapy’s CFRs and reimbursement rates. Work with Kidz Therapy officials to help …
https://www.osc.ny.gov/state-agencies/audits/2016/09/15/kidz-therapy-services-pllc-compliance-reimbursable-cost-manualSmall Wonder Preschool, Inc. – Compliance With the Reimbursable Cost Manual
… on Small Wonder’s CFR for the fiscal year ended June 30, 2021 and certain expenses claimed on its CFRs for the 2 fiscal years ended June 30, 2020. About the Program Small Wonder is a New York … reported on CFRs. During the fiscal year ended June 30, 2021, Small Wonder served approximately 85 students in …
https://www.osc.ny.gov/state-agencies/audits/2024/09/05/small-wonder-preschool-inc-compliance-reimbursable-cost-manualState Comptroller DiNapoli Releases State Audits
… the following audits have been issued: City University of New York (CUNY): Administration of Fellowship Leaves (Follow-Up) (2015-F-5) An initial audit … for one. Auditors identified two accounts that were not on CUNY’s list. These findings point to weaknesses in the …
https://www.osc.ny.gov/press/releases/2016/08/state-comptroller-dinapoli-releases-state-audits-0State Comptroller DiNapoli Releases Audits
… $263,196 in ineligible costs that ABC reported for reimbursement and recommend such costs be disallowed. These …
https://www.osc.ny.gov/press/releases/2019/03/state-comptroller-dinapoli-releases-auditsMedicaid Program – Medicaid Payments to Medicare Advantage Plan Providers
… through Medicare Advantage plans, which have networks of participating providers that they reimburse for services … plan contracts offered by Fidelis and WellCare and, based on judgmental sampling, determined certain providers reported … on 7,072 Medicaid claims resulting in overpayments of $770,935. We determined three of the providers were …
https://www.osc.ny.gov/state-agencies/audits/2018/09/10/medicaid-program-medicaid-payments-medicare-advantage-plan-providersDiNapoli: Managed Care Companies Wasting Millions in State Medicaid Dollars
… and Amerigroup, managed care organizations (MCOs) that contract with the Department of Health (DOH) to provide health services under the state’s Medicaid program, made at least $6.6 million in … deceased doctors, according to an audit released today by State Comptroller Thomas P. DiNapoli. “These organizations …
https://www.osc.ny.gov/press/releases/2016/07/dinapoli-managed-care-companies-wasting-millions-state-medicaid-dollarsXII.6.I Paying a Non-State Employee – XII. Expenditures
… a payment to an individual who provided services to the State. Paying non-employee travel Paying expenses for … even though the Business Unit may have entered into a contract. The Business Unit will process these payments …
https://www.osc.ny.gov/state-agencies/gfo/chapter-xii/xii6i-paying-non-state-employeeLeague for the Handicapped – Compliance With the Reimbursable Cost Manual
… calculated, adequately documented and allowable under the State Education Department’s (SED) guidelines, including the … as needed. Other Related Audits/Reports of Interest State Education Department: Summit Educational Resources - Compliance With the Reimbursable Cost Manual (2014-S-49) State Education Department: Newmeadow, Inc. - Compliance With …
https://www.osc.ny.gov/state-agencies/audits/2016/06/03/league-handicapped-compliance-reimbursable-cost-manualCUNY Bulletin No. CU-547
… Purpose To notify agencies that newly established FICA tax deficiency … CUNY (SS/Medicare Deficiency) with an effective date prior to 9/1/16 and will remain at their current rate. Affected …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-547-new-repayment-rate-deduction-code-582-cuny-ssmedicareState Agencies Bulletin No. 1493
… share that was remitted to the IRS by the Office of the State Comptroller on their behalf. Failure to quickly begin … penalties by the IRS for the years of non-payment. The State remains in compliance with the error-correction … of the Treasury Regulations under IRC section 6205 if the State consistently makes reasonable efforts to obtain …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1493-new-repayment-rate-deduction-code-502-nys-ssmedicare-deficiencyEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… paid claims for special items according to the provisions of the agreements between Empire and its member hospitals. We … district employees and their dependents. The Department of Civil Service contracts with Empire to administer the … Payments for hospital services are generally based on standard fee schedules. However, hospitals may be entitled …
https://www.osc.ny.gov/state-agencies/audits/2013/05/09/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughMedicaid Program: Overpayments for Medicare Part C Claims (2023-S-13)
To determine whether Medicaid made improper payments on Medicare Part C claims for recipients covered by Medicare Advantage Plans.
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2025-23s13.pdfImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… Objective To assess the extent of implementation of the nine recommendations included in our initial audit … services and payments. We issued our initial audit report on December 28, 2020. The audit objective was to determine …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followLong Island Association for AIDS Care
… report 2012-0063 , entitled the Long Island Association for AIDS Care, Inc. (LIAAC). Based on information obtained … of the documents LIAAC submitted to support the reimbursement for employee health insurance (i.e., medical … our examination of medical and dental expenses claimed for reimbursement by LIAAC under their contracts with the …
https://www.osc.ny.gov/state-agencies/audits/2017/11/10/long-island-association-aids-care