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New Contracts Eligibility Determination

Provides guidance for State authorities to identify new contracts that must be submitted to OSC for filing or for prior approval.

West Corners Fire Company – Accounting for Cash Receipts and Disbursements (2014M-215)

… ensured that the Treasurer was properly accounting for cash receipts and disbursements for the period January 1, 2013 through May 16, 2014. … that is located in, and provides fire protection services for, the Town of Union in Broome County. The Company’s …

DiNapoli: State Pays Drug Treatment Center Nearly $4 Million for Ineligible Expenses

… by New York State Comptroller Thomas P. DiNapoli. "Phoenix House is contracted to provide services to New Yorkers who … signed a five-year $47.6 million contract with Phoenix House New York (PHNY) in 2009 to provide outpatient, …

DiNapoli Audit Highlights Need for Better Compliance with School Violence Reporting Law

… The State Education Department (SED) has agreed to improve its enforcement of the Safe Schools Against Violence in … and are being given proper warning if problems are happening.” The SAVE Act requires SED, school districts and … … The State Education Department SED has agreed to improve its enforcement of the Safe Schools Against Violence in …

Monitoring of Not-for-Profit Cemeteries for Fiscal Stability and Adequate Facility Maintenance (Follow-Up)

… Stability and Adequate Facility Maintenance ( 2016-S-79 ). Background The Department of State’s (Department) … corporations (cemeteries) in New York State. As authorized by Article 15 of the Not-for-Profit Corporation Law (Law), … condition of 64 cemeteries using two measures developed by the Division found Permanent Maintenance Funds at 37 …

Medicaid Program – Opioid Prescriptions for Medicaid Recipients in an Opioid Treatment Program

… Purpose To determine if the Department of Health has taken sufficient steps to … maximize safety of patient care, Treatment Programs should check I-STOP and, with a patient’s consent (as required by …

Medicaid Program – Medicaid Overpayments for Medicare Part B Services Billed Directly to eMedNY

… whether Medicaid made improper payments to providers who submitted Part B cost-sharing claims directly to eMedNY. … to minimize the need for providers to self-report Medicare claim data to eMedNY and thereby improve the accuracy of … Questionable payments totaling $5.3 million to providers who claimed excessive Part B coinsurance amounts. …

School for Language and Communication Development – Compliance With the Reimbursable Cost Manual

… To determine whether the costs reported by the School for Language and Communication Development (SLCD) on its … 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. Background SLCD …

UnitedHealthcare – 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 … for NYSHIP. The Empire Plan provides its members with four types of health insurance coverage: medical/surgical, … portion of the Empire Plan. Medical/surgical benefits cover a range of services including, but not limited to: …

Children’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual

… To determine whether the costs reported by Children’s Unit for Treatment and Evaluation (CUTE) on its Consolidated … (RCM). The audit covered expenses reported on CUTE’s CFR for the fiscal year ended June 30, 2016 and certain costs reported on its CFRs for the two fiscal years ended June 30, 2015. About the …

Educators for Children, Youth and Families, Inc. – Use of Contract Funds (Follow-Up)

… included in our initial audit report, Educators for Children, Youth and Families, Inc. - Use of Contract … received from the State Education Department (SED) and the Office of Children and Family Services (OCFS) under grant … Audit/Report of Interest State Education Department/Office of Children and Family Services:  Educators for …

Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 3, 4, 5 and 6 Members – Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 3, 4, 5 and 6 Members

Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 1 and 2 Members – Sheriffs, Undersheriffs and Deputy Sheriffs Special Plan for ERS Tier 1 and 2 Members

Medicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance

… Purpose To determine whether the Department of Health (Department) made Medicaid mainstream managed care … No Longer Enrolled in Mainstream Managed Care and Family Health Plus ( 2015-S-47 ) … To determine whether the Department of …

UnitedHealthcare – 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 2013-S-82 ). Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage …

Changes 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 … policies could affect the city’s economy and finances. The House of Representatives and the Senate have reached … agencies could be higher than planned; Proceeds from the sale of taxi medallions could fall short of expectations …

Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber

… To determine whether Medicaid made proper payments to Joia Pharmacy, Inc. (Joia) and a related prescriber (herein … During the audit period, Joia, doing business as Soho Pharmacy, was a privately owned pharmacy located in Lower …

Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)

… Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11). Background Our initial … Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-11) United HealthCare … Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (2012-S-10) … Determine the extent …

Medicaid 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 …

DiNapoli Statement on Greenville Arrest for Alleged Theft of Taxpayer Funded Resources

… Police, Mr. Williams' alleged acts have been brought to light and he will be held accountable." … New York State …