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DiNapoli: Former Non-Profit Executive Pleads Guilty to Falsifying Business Records
… holiday hours. Thurber also improperly gave herself 66 additional hours of leave accruals and misrepresented her … by filing a complaint online at https://www.osc.state.ny.us/investigations , or by mailing a complaint to: Office … of Investigations, 8th Floor, 110 State St., Albany, NY 12236. …
https://www.osc.ny.gov/press/releases/2021/08/dinapoli-former-non-profit-executive-pleads-guilty-falsifying-business-recordsLong Island Association for AIDS Care
… for employee health insurance (i.e., medical and dental expenses). As a result, we continued our examination of medical and dental expenses claimed for reimbursement by LIAAC under … for payment totaling $120,293 for employee medical and dental expenses for the period February 2014 through May …
https://www.osc.ny.gov/state-agencies/audits/2017/11/10/long-island-association-aids-careAllocation, Billing, and Collection of Expenses of Administering the Motor Vehicle Financial Security Act and the Motor Vehicle Safety Responsibility Act (Follow-Up)
… to the Acts fall into three program areas: the Dedicated Bridge and Highway Safety Program, the Compulsory Insurance … the Department was appropriately allocating, billing, and collecting the expenses of administering the Acts. We found … the Department was appropriately allocating, billing, and collecting nearly all expenses related to administering the …
https://www.osc.ny.gov/state-agencies/audits/2021/05/27/allocation-billing-and-collection-expenses-administering-motor-vehicle-financial-securityMedicaid Program - Medicaid Managed Care Organization Fraud and Abuse Detection
… testing, we were unable to determine the full extent of MCO payments attributable to excluded providers because many MCO encounter claims (totaling about $445 million) lacked … inadequate annual training. Key Recommendations We made 11 recommendations to the Department, including: Ensure …
https://www.osc.ny.gov/state-agencies/audits/2016/07/15/medicaid-program-medicaid-managed-care-organization-fraud-and-abuse-detectionMedicaid Program – Administrative Costs Used in Premium Rate Setting of Mainstream Managed Care Organizations
… applying the administrative costs in determining MCO premium rates. Our audit covered the period January 1, … care premium rates, which are based, in part, on allowable MCO administrative costs. For this purpose, the Department … of these payments, the Department does not adjust each MCO’s premium to reflect the MCO’s actual facilitated …
https://www.osc.ny.gov/state-agencies/audits/2017/09/13/medicaid-program-administrative-costs-used-premium-rate-setting-mainstream-managed-careImproper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Follow-Up)
… Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare (Report 2018-S-71 ). About the … care, including nursing, physician, and counseling services; home health aides; physical and occupational … Medicare is the primary payer for Medicare-covered hospice services, while Medicaid is the payer of last resort. In …
https://www.osc.ny.gov/state-agencies/audits/2023/02/13/improper-medicaid-payments-individuals-receiving-hospice-services-covered-medicare-followCrossroads Center for Children – Compliance With the Reimbursable Cost Manual
… not-for-profit organization located in Schenectady, New York. Crossroads provides preschool special education … materials that were purchased with private grant funds; $2,281 for non-audit services that were performed by …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/crossroads-center-children-compliance-reimbursable-cost-manualAstor Services for Children & Families – Compliance With the Reimbursable Cost Manual
… State Education Department: Clinical Associates of the Finger Lakes - Compliance With the Reimbursable Cost Manual …
https://www.osc.ny.gov/state-agencies/audits/2015/09/02/astor-services-children-families-compliance-reimbursable-cost-manualChildren’s Unit for Treatment and Evaluation – Compliance With the Reimbursable Cost Manual
… To determine whether the costs reported by Childrens Unit for Treatment and Evaluation on its …
https://www.osc.ny.gov/state-agencies/audits/2019/07/15/childrens-unit-treatment-and-evaluation-compliance-reimbursable-cost-manualUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… claims is 80 percent of the R&C rate for the service. R&C rates are updated every six months. From January 1, 2017 … million for 255,807 out-of-network claims based on R&C rates. Key Findings United's automated claims processing … the two most recent R&C rate periods (i.e., reimbursement rates from the prior 12 months) to process all R&C claims – …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsAssociation for the Advancement of the Blind and Retarded – Options for People Through Services Program
… Purpose To determine whether payments made by the Office for People With Developmental Disabilities (OPWDD) to the Association for the Advancement of Blind and Retarded (AABR) for the Options for People … To determine whether payments made by the New York State Office For People With Developmental …
https://www.osc.ny.gov/state-agencies/audits/2013/07/26/association-advancement-blind-and-retarded-options-people-through-services-programWest Seneca Fire District #2 – Purchasing and Capital Project Management (2018M-241)
… than $115,000. District officials did not obtain quotes for 16 of 21 purchases totaling approximately $56,000. The … may have improperly charged the District more than $14,000 for administrative fees and sales tax. Key Recommendations … legal counsel and, if appropriate, seek reimbursement for the improper charges. District officials generally agreed …
https://www.osc.ny.gov/local-government/audits/fire-district/2019/08/30/west-seneca-fire-district-2-purchasing-and-capital-project-management-2018mState Comptroller DiNapoli Releases Audits
New York State Comptroller Thomas P DiNapoli announced today the following audits have been issued
https://www.osc.ny.gov/press/releases/2023/02/state-comptroller-dinapoli-releases-auditsTown of Essex – Internal Controls Over Selected Financial Operations (2015M-60)
… is governed by an elected five-member Town Board, has one water district and one sewer district. Budgeted … The Town lacked comprehensive policies and procedures for water and sewer charges, resulting in weaknesses over billing, collecting and enforcing of water and sewer charges. Town officials did not establish an …
https://www.osc.ny.gov/local-government/audits/town/2015/08/07/town-essex-internal-controls-over-selected-financial-operations-2015m-60Motor Vehicle Theft and Insurance Fraud Prevention Program
… Objective To determine whether the Division of Criminal Justice Services (DCJS) has complied with Article … To determine whether the Division of Criminal Justice Services DCJS has complied with Article 36A …
https://www.osc.ny.gov/state-agencies/audits/2024/04/11/motor-vehicle-theft-and-insurance-fraud-prevention-programCenter for Disability Services – Compliance With the Reimbursable Cost Manual
… adequately documented, and allowable under the State Education Department’s (SED) guidelines, including the … Background CFDS is an SED-approved not-for-profit special education provider located in Albany, New York. CFDS provides preschool special education services to children with disabilities between the …
https://www.osc.ny.gov/state-agencies/audits/2016/05/13/center-disability-services-compliance-reimbursable-cost-manualCantalician Center for Learning – Compliance With the Reimbursable Cost Manual
… Objective To determine whether the costs reported by Cantalician Center for Learning (Cantalician) on its Consolidated Fiscal Reports … calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including … To determine whether the costs reported by Cantalician Center for Learning on its …
https://www.osc.ny.gov/state-agencies/audits/2023/01/26/cantalician-center-learning-compliance-reimbursable-cost-manualAudit of the Tuition Reimbursement Account for the Three Fiscal Years Ended March 31, 2013
… Purpose To express an opinion on the fair presentation of the Financial Statements of the Tuition Reimbursement Account for the three fiscal years … To express an opinion on the fair presentation of the Financial Statements of the Tuition Reimbursement Account …
https://www.osc.ny.gov/state-agencies/audits/2014/07/24/audit-tuition-reimbursement-account-three-fiscal-years-ended-march-31-2013Medicaid Program – Claims Processing Activity October 1, 2023 Through March 31, 2024
… Medicaid recipients who should not have had managed care coverage because they had other concurrent comprehensive … on behalf of incarcerated recipients whose managed care coverage should have been suspended. As a result of the …
https://www.osc.ny.gov/state-agencies/audits/2025/02/06/medicaid-program-claims-processing-activity-october-1-2023-through-march-31-2024DiNapoli: New York's Medicaid System Improperly Paid Over $16 Million in Claims
… released today by State Comptroller Thomas P. DiNapoli. “My office pays close attention to Medicaid because it’s … The bulk of the improper payments, $11.8 million, went to pay 27,480 Medicaid managed care premiums for recipients who … including informing hospitals to accurately report to and bill Medicaid, along with identifying where financial …
https://www.osc.ny.gov/press/releases/2025/02/dinapoli-new-yorks-medicaid-system-improperly-paid-over-16-million-claims