Search
Medicaid Program – Claims Processing Activity April 1, 2020 Through September 30, 2020
… Department’s prompt attention, as follows: $4.5 million was paid for an incorrect retroactive rate adjustment; $2.1 million was paid for inpatient claims that were billed at a higher level of care than what was actually provided; $892,790 was paid for services …
https://www.osc.ny.gov/state-agencies/audits/2021/09/21/medicaid-program-claims-processing-activity-april-1-2020-through-september-30-2020Medicaid Program – Suspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists
… Purpose To determine if six affiliated Brooklyn dentists billed Medicaid for services that were not … To determine if six affiliated Brooklyn dentists billed Medicaid for services that were not …
https://www.osc.ny.gov/state-agencies/audits/2013/04/04/medicaid-program-suspicious-and-fraudulent-medicaid-payments-affiliated-brooklyn-dentistsKids Quality Care, Inc. – Compliance With the Reimbursable Cost Manual
… (KTI). The New York City Department of Education (DoE) pays tuition and fees to KQC using rates set by SED, … in an annual CFR filed with SED. SED reimburses the DoE for a portion of its payments to KQC. For the two fiscal …
https://www.osc.ny.gov/state-agencies/audits/2013/02/07/kids-quality-care-inc-compliance-reimbursable-cost-manualMedicaid Program – Improper Payments for Drugs Without a Federal Drug Rebate Agreement
… To determine whether Medicaid inappropriately paid for drugs from manufacturers that did not enter into a … the Department of Health and Human Services in exchange for state Medicaid coverage of most of the manufacturer’s … Manufacturers then pay states rebates on those drugs for which Medicaid payments were made. Covered outpatient …
https://www.osc.ny.gov/state-agencies/audits/2024/02/23/medicaid-program-improper-payments-drugs-without-federal-drug-rebate-agreementNational School Lunch, Breakfast Programs – Federal Funding and New York
… (Assistance Living Number 10.553) provide low-cost or free breakfast and lunch to students in public and non-profit private schools across the United … in the United States. Nationally, children qualify for free breakfast and lunch if a family's income is at or below …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/national-school-lunch-breakfast-programsTitle IV-E Foster Care – Federal Funding and New York
… Title IV-E of the Social Security Act (Assistance Listing Number 93.658) … Funds are allocated to New York State and pass through to the City, and are used for ongoing foster care expenses (like … is specifically for children who have been removed from the home of a guardian due to a lack of care or supervision …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/title-iv-e-foster-careMedicaid Program – Claims Processing Activity April 1, 2024 Through September 30, 2024
… ensured that Medicaid claims were submitted by approved providers, were processed in accordance with Medicaid requirements, and resulted in correct payments to providers. The audit covered the period from April 2024 … DOH’s eMedNY computer system processes claims submitted by providers for services rendered to Medicaid-eligible members …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/medicaid-program-claims-processing-activity-april-1-2024-through-september-30-2024Medicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… or via referral from those providers. Generally, claims for non-emergency services submitted for a restricted recipient should not be paid if the service is not provided or referred by the designated providers. The … providers on file in eMedNY, yet received services that were not furnished or referred by the designated providers. …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientOpinion 2006-11
… or statutory amendments that bear on the issues discussed in the opinion. CONFLICTS OF INTEREST -- Purchases and Sales … duties exception) GENERAL MUNICIPAL LAW §802(1)(b): When a town board member has an interest in town purchases from an … voting, on matters pertaining to purchases from the store. You ask whether a salaried town board member would have a …
https://www.osc.ny.gov/legal-opinions/opinion-2006-11Opinion 92-20
… views if, among other things, there have been subsequent court cases or statutory amendments that bear on the issues … fairgrounds. The fair is held one week during the year on land within the town owned by a private person, who is also … the town" (Town Law, §136[3]; see also Municipal Home Rule Law, §10[1][ii][a][12], relative to a local government's …
https://www.osc.ny.gov/legal-opinions/opinion-92-20Opinion 89-52
… and Duties (power to coordinate training of emergency medical service providers) LOCAL LAWS -- Preemption (county coordination of emergency medical service training) PUBLIC HEALTH LAW, §§3000, 3051, … 3052: A county may establish the position of emergency medical services coordinator provided that the …
https://www.osc.ny.gov/legal-opinions/opinion-89-52Opinion 94-25
… FIREFIGHTERS -- Service Award Program (service credit for attending meetings of groups within a fire department or … year of firefighting service under a service award program for attendance at "meetings" of an emergency rescue and first … year of firefighting service under a service award program for attendance at "meetings" of groups formed within a fire …
https://www.osc.ny.gov/legal-opinions/opinion-94-25Opinion 90-22
… FUNDS -- Deposits and Investments (of consumer deposits for municipal water utility) PUBLIC SERVICE LAW, §§89- 1 , … 117; GENERAL MUNICIPAL LAW, §11: A municipal water utility is not required by Public Service Law, §117 to pay interest … decision (see, e.g., 1981 Opns St Comp No. 81-27, p 26; 1979 Opns St Comp No. 79-754, p 154; 24 Opns St Comp, …
https://www.osc.ny.gov/legal-opinions/opinion-90-22Opinion 88-61
… is dated by postmark with a date on or before the last day for the payment of taxes without penalty. You ask whether … U.S. Postal Service postmarked with the date of the last day for the payment of school taxes without interest may be … in an envelope postmarked with a date after the last day for the payment of taxes without interest and that you …
https://www.osc.ny.gov/legal-opinions/opinion-88-61Opinion 88-8
… §802 apply. Abstention from voting on matters relating to the contracts between the district and his company would … a fire district may engage a local automotive dealership to service its vehicles if a member of the board of fire … dealership and abstains from voting with respect to any matters relating to the service contracts. Article 18 …
https://www.osc.ny.gov/legal-opinions/opinion-88-8DiNapoli: Paycheck Protection Program in NYC Stumbled, but Finding Footing
… meeting the program’s rigid requirements and lacked access to major lenders, according to a report released today by State Comptroller Thomas P. DiNapoli. “The PPP was meant to be a lifeline for struggling small businesses, but it has … meeting the programs rigid requirements and lacked access to major lenders …
https://www.osc.ny.gov/press/releases/2021/02/dinapoli-paycheck-protection-program-nyc-stumbled-finding-footingPayroll Improvement Project Bulletin No. PIP-012
… system will automatically calculate Addl Pay adjustments for certain Addl Pay changes. Addl Pay Proration affects the … PS1 and PS3, and Administrative Maintenance Pay (AMP) for certain Security bargaining units. Note: Overpayment … effective in the current pay period and processed for the current pay period: Placed on a Paid Leave of …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/payroll-improvement-project/pip-012-changes-mid-pay-period-additional-payThe Network for Children’s Speech, Occupational & Physical Therapy, LLC – Compliance With the Reimbursable Cost Manual
… with disabilities who are between three and five years of age. CTN is reimbursed for preschool special education … included: $668,259 in personal service costs, consisting of $511,672 in overstated personal service costs for special … in other than personal service costs, which consisted of $13,574 in insufficiently documented expenses, $13,491 in …
https://www.osc.ny.gov/state-agencies/audits/2018/07/03/network-childrens-speech-occupational-physical-therapy-llc-compliance-reimbursable-costAlternatives For Children – Compliance With the Reimbursable Cost Manual
… of $37,446 in expensed equipment that was not properly capitalized and depreciated; $35,956 in rent expenses for a …
https://www.osc.ny.gov/state-agencies/audits/2018/04/05/alternatives-children-compliance-reimbursable-cost-manualSelected Aspects of Inspecting and Licensing Radioactive Materials and Radiation Equipment
… inspected; facilities complied with selected licensing and registration regulations; and identified violations were … renewed, and amended radioactive material licenses and the registration of facilities with radiation equipment. To … inspect all licensed and registered facilities. Licensing, registration, and inspection helps to protect and safeguard …
https://www.osc.ny.gov/state-agencies/audits/2018/08/21/selected-aspects-inspecting-and-licensing-radioactive-materials-and-radiation-equipment