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United HealthCare – Overpayments for Services Provided by Hudson Valley Bone and Joint Surgeons, LLP
… Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from this practice. The audit covered the period January 1, 2011 through October 31, 2015. … Plan members outofpocket costs and if so to quantify the overpayments made by …
https://www.osc.ny.gov/state-agencies/audits/2016/09/08/united-healthcare-overpayments-services-provided-hudson-valley-bone-and-joint-surgeons-llpState Comptroller DiNapoli Releases Audits
… Insurance Program: CVS Caremark – Accuracy of Empire Plan Commercial Rebate Revenue Remitted to the Department of Civil …
https://www.osc.ny.gov/press/releases/2025/04/state-comptroller-dinapoli-releases-auditsUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers (Follow-Up)
… audit report, Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers … of the Empire Plan (medical/surgical benefits cover services such as physician office visits, diagnostic testing, … ASCs have contract provisions that require all anesthesia services provided to Empire Plan members at their facilities …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryDiNapoli Finds Over $100 Million in Inappropriate Medicaid Payments
… released three reports that found more than $100 million in improper payments made by the Department of Health (DOH) for the Medicare buy-in program, maternity care, and drug and therapy claims. Nearly $400,000 in premiums may have been paid for deceased individuals. “The …
https://www.osc.ny.gov/press/releases/2021/11/dinapoli-finds-over-100-million-inappropriate-medicaid-paymentsMedicaid Overpayments for Medicare Advantage Plan Services (Follow-Up)
… initial audit report, Medicaid Overpayments for Medicare Advantage Plan Services (Report 2017-S-46 ). About the … commonly referred to as Medicare Managed Care or Medicare Advantage. Under Part C, managed care companies administer … offer different health care plans (referred to as Medicare Advantage plans [Plans]) to meet the specific needs of …
https://www.osc.ny.gov/state-agencies/audits/2020/07/01/medicaid-overpayments-medicare-advantage-plan-services-followState Agencies Bulletin No. 468
… Wage Adjustment used by OSC in Time Entry for processing app …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/468-new-earnings-codes-current-year-social-security-and-medicare-adjustmentsMadrid-Waddington Central School District - Claims Audit Process (2019M-1)
… purposes and were properly audited and approved prior to payment. Key Findings We reviewed 100 claims … addition, two claims totaling $17,848 were improperly paid prior to audit. The claims auditor did not audit and approve … are presented to the claims auditor for audit and approval prior to payment. Ensure no claims, other than those allowed …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1Excessive Medicaid Payments for Services to Recipients Receiving Medicare Benefits (Follow-Up)
… recommendations included in our initial audit report, Excessive Medicaid Payments for Services to Recipients … Related Audit/Report of Interest Department of Health: Excessive Medicaid Payments for Services to Recipients … of 3 recommendations incld in our initial audit report Excessive Medicaid Payments for Services to Recipients …
https://www.osc.ny.gov/state-agencies/audits/2013/04/26/excessive-medicaid-payments-services-recipients-receiving-medicare-benefits-followCUNY Bulletin No. CU-356
… are eligible to participate in the New York State Health Insurance Plan (NYSHIP) administered by the New York State … and simultaneously employed in one of the following titles: Graduate Assistant A, B or C Adjunct Instructor … of Civil Service to start, cancel or change rates for individual employees. Agencies will not have PayServ …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-356-certain-cuny-employees-eligible-new-york-state-healthDiNapoli: Audit Finds More Than $16 Million in Medicaid Cost Savings
… another $3 million in cost savings. About $1.8 million of the overpayments were recovered before the close of the … for newborn claims that were submitted with incorrect birth weights; $471,321 in overpayments for claims billed … Medicaid paid nine of the 15 a total of $99,038 from the date they were charged with a crime to their termination …
https://www.osc.ny.gov/press/releases/2017/07/dinapoli-audit-finds-more-16-million-medicaid-cost-savingsState Agencies Bulletin No. 914
… agencies of new procedures regarding withholding of Social Security and Medicare taxes for employees receiving a … income paid as a military stipend is exempt from Social Security and Medicare taxes and must be reported on a Form … wages, subject to income tax withholdings but not Social Security or Medicare taxes. This regulation impacts wages …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/914-change-taxation-military-stipendsDiNapoli: State Medicaid Needs to Stop Paying Bills That Federally Funded Plans Should Cover
… if it strengthens its oversight of enrollment in Medicaid and other public health plans, according to two audits … to identify those who appear eligible for Medicare and have them apply. DiNapoli’s audit , which covered the … covered by federal funds. DOH administers both Medicaid and the Essential Plan. Because the qualifications for …
https://www.osc.ny.gov/press/releases/2023/09/dinapoli-state-medicaid-needs-stop-paying-bills-federally-funded-plans-should-coverUnited HealthCare – Overpayments for Services Provided by Long Island Bone and Joint, LLP
… Purpose To determine whether Long Island Bone and Joint, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from … claim. Our audit focused on claims submitted to United by Long Island Bone and Joint, LLP (LI Bone and Joint), a …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/united-healthcare-overpayments-services-provided-long-island-bone-and-joint-llpState Comptroller DiNapoli Releases Audits
… and Substance Abuse Services for Ineligible Members (2021-S-18) The New York State Health Insurance Program … Act for the Three State Fiscal Years Ended March 31, 2021 (2021-M-2) The acts help ensure that the operators of motor …
https://www.osc.ny.gov/press/releases/2022/06/state-comptroller-dinapoli-releases-auditsState Comptroller DiNapoli Releases Audits
… been issued. Empire State Development – COVID-19 Pandemic Small Business Recovery Grant Program (2023-S-10) Empire … (ESD) was charged with administering the COVID-19 Pandemic Small Business Recovery Grant Program (Program) designed to support small businesses or for-profit independent arts and cultural …
https://www.osc.ny.gov/press/releases/2025/05/state-comptroller-dinapoli-releases-auditsCUNY Bulletin No. CU-531
… new flat rate deduction codes that will be used to recover Medicare and Social Security tax deficiencies for City … (CUNY) employees. Affected Employees CUNY employees with Medicare and/or Social Security deficiency Effective Date(s) … to the Payroll Deductions mailbox. Questions regarding Medicare and/or Social Security tax deficiencies may be …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-531-new-deduction-codes-580-city-university-new-york-medicareEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… acquisition costs. Background The New York State Health Insurance Program (NYSHIP) provides health coverage to active … which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughNew York State Health Insurance Program – Payments by CVS Health for Pharmacy Services for Ineligible Members (Follow-Up)
… in our initial audit report, Payments by CVS Health for Pharmacy Services for Ineligible Members (Report 2020-S-17 ). About the Program … and Accounting System (NYBEAS), the system of record for member enrollment and eligibility information. Civil … in our initial audit report Payments by CVS Health for Pharmacy Services for Ineligible Members Report 2020S17 …
https://www.osc.ny.gov/state-agencies/audits/2023/01/04/new-york-state-health-insurance-program-payments-cvs-health-pharmacy-services-ineligibleOpinion 97-2
… ch 689) generally provides, among other things, for the regulation and certification by the State Superintendent of …
https://www.osc.ny.gov/legal-opinions/opinion-97-2NYSHIP: Payments by Empire BlueCross for Hospital Services for Ineligible Members (2019-S-32)
To determine whether Empire BlueCross paid hospital claims for members who were not eligible. The audit covered the period January 1, 2014 through December...
https://www.osc.ny.gov/files/state-agencies/audits/pdf/sga-2020-19s32.pdf