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Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
… (Joia) and a related prescriber (herein referred to as “the Doctor”) in compliance with applicable Medicaid laws and regulations as well as the rules and policies set forth by the Department of Health (Department) and the State Education …
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
… renal disease who were eligible for, but not enrolled in, Medicare. The audit covered the period January 1, 2010 … with ESRD. Medicaid recipients with ESRD are eligible for Medicare coverage if they receive regular dialysis treatments … When Medicaid recipients with ESRD are also enrolled in Medicare, Medicare becomes the primary insurer (payer) and …
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
… Since our 2016 report, OTDA has established a standard checklist that SSDs can use to guide required six-month … full understanding of the goals of the overall inspection checklist as well as the inspection function. Establish a …
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
… 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 … to receive such payments, $12,857 that exceeded the 3.5 percent limit set by SED, and $6,444 that was not supported …
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
… 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-manualPayments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… of implementation of the three recommendations included in our initial audit report, Payments for Fraudulent and … 10, 2015, William Davis pleaded guilty to Grand Larceny in the Second Degree in Nassau County District Court. He was sentenced on February …
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
… New York State Comptroller Thomas P. DiNapoli released the following statement regarding the arrest of Terry Williams for alleged theft of fuel from the Town of Greenville Highway Department. The …
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
… in Feb. 2015. She has worked in a variety of roles on Wall Street, including emerging markets, interest rates trading …
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
… citywide savings program and better-than-expected pension fund investment earnings last year. The gaps are relatively … could be used to narrow the budget gaps if not needed for other purposes. The city’s financial plan has a general … spending. The city anticipates receiving $8.3 billion from the federal government in FY 2018, which represents …
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
… disadvantaged and/or have special health care needs. In general, the Medicaid program pays medical providers … 29,289 fee-for-service pharmacy claims totaling $978,251 on behalf of 18,010 recipients whose pharmacy benefits were … 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
… to federal fraud charges earlier this year, as a result of a joint investigation by New York State Comptroller Thomas … to a year and one day in prison and ordered to pay a total of $721,112 in restitution and criminal forfeiture. “Joseph … for cancer and used the money to fund his lavish lifestyle of world traveling and gambling,” DiNapoli said. “This …
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
… Purpose To determine whether Orthopedic Associates of Long Island, LLP waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made … primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital care to outpatient …
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
… manner.” Currently, there are ten causes that New Yorkers can support through personal income tax check-offs, including … and exploited children efforts; veterans’ causes; and disease research. Taxpayers will be able to contribute to a … starting with the 2015 tax year. A 2014 State Comptroller’s report found that over the previous five years, receipts …
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)
… of implementation of the nine recommendations included in our initial audit report, Improper Medicaid Payments for … and supplies; and drugs. When individuals are enrolled in both Medicaid and Medicare (referred to as … services, while Medicaid is the payer of last resort. In addition to delivering services, hospice providers are …
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
… of Social Services and retired in 1994. Upon her retirement she received monthly benefits of approximately … her personal account. Forensic auditors traced the stolen money from the bank accounts, which Chatley held jointly with … of fraud involving taxpayer money by calling the toll-free Fraud Hotline at 1-888-672-4555, by filing a complaint …
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
… programs may not be adequately prepared in an emergency to prevent gaps in care, which could compromise patient progress or safety, according to a new audit released today by New York State Comptroller … P. DiNapoli. The audit, which covered the period from 2019 to 2022, found the state’s Office of Addiction Services and …
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
… New York State Comptroller Thomas P. DiNapoli and the New York State Police announced the arrest of Village of …
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
… Purpose To determine whether the Department of Health's eMedNY system processes Medicaid claims for … rates for inpatient hospital claims include the costs of most medical care provided during a hospital …
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 dealing with … expenses and may provide them with more options for care." DiNapoli said. "The state has an obligation not …
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
… be made through the pension fund’s In-State Private Equity Investment Program, designed to make profitable investments … pension fund, I’m committed to seeking out profitable investment opportunities for the Retirement System’s members, … Read about the pension fund’s In-State Private Equity Investment Program . About the Common Retirement Fund New …
https://www.osc.ny.gov/press/releases/2015/03/state-pension-fund-adds-30-million-investments-new-york-companies