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

… submitted Part B cost-sharing claims directly to eMedNY. The audit covered the period from June 1, 2012 through May 31, 2017. Background Many of the State’s Medicaid recipients are also eligible for … under 65 with certain disabilities. Individuals enrolled in both programs are commonly referred to as “dual-eligible.” …

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 premium payments on behalf of individuals who had … As of August 2017, 4.4 million people were enrolled in mainstream managed care plans – about 2.5 million were …

UnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)

… to medical providers are based, in part, on procedure codes billed on claims that indicate the medical services … assessment to identify providers with unusual modifier 59 billing patterns and take appropriate actions, including … new fraud and abuse detection program to identify aberrant billing patterns, including inappropriate uses of modifier …

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

… the following statement regarding the arrest of Terry Williams for alleged theft of fuel from the Town of … by DiNapoli’s office and the New York State Police. "Mr. Williams allegedly abused his position by taking, for his own … my ongoing partnership with the New York State Police, Mr. Williams' alleged acts have been brought to light and he will …

DiNapoli Announces Interim CIO for the New York State Common Retirement Fund

… retiring the week of July 30 after six years of service. "My thanks go to Vicki Fuller, during whose tenure the Fund … public employees, retirees and their beneficiaries." "My gratitude goes to Comptroller DiNapoli for his trust and …

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

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

UnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers

… Purpose To determine whether UnitedHealthcare overpaid for … Surgery Centers that were contractually required to use in-network anesthesia providers. The audit covered the …

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

… Objective To determine whether the costs reported by Children’s Unit for Treatment and Evaluation (CUTE) on its Consolidated Fiscal Reports … calculated, adequately documented, and allowable under the State Education Department’s (SED) guidelines, including …

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

… of implementation of the three recommendations included in our initial audit report, Educators for Children, Youth … claims amounting to $1.8 million, out of $3.2 million in contract payments, to determine if the claims were … fraudulent transactions to an inactive Board of Directors. In addition, we found no evidence that there were any …

DiNapoli: Contractor Sentenced in Federal Court for Defrauding State of Over $360,000

… statewide to combat corruption in the misuse of public funds.” Junkovic, 49, of the Bronx, pleaded guilty in … Bilingual SEIT and Preschool Inc. DiNapoli encourages the public to help fight fraud and abuse. New Yorkers can report …

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

… Services (OASAS), according to an audit released today by New York State Comptroller Thomas P. DiNapoli. "Phoenix House is contracted to provide services to New Yorkers who …

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

… (SED) has agreed to improve its enforcement of the Safe Schools Against Violence in Education Act (SAVE Act) after a state audit found schools … extent to which the seventh school, Burgard Vocational High School in Buffalo, underreported because it used an …

Lifeline Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual

… the ages of three and five years. During the 2014-15 school year, Lifeline served about 52 students. The New York … space and staff with a DoE District 75 program that serves school-age special education students. Key Findings For the …

Brookville Center for Children’s Services, Inc. – Compliance With the Reimbursable Cost Manual

… Purpose To determine whether the costs reported by Brookville Center for Children’s … directly related to the special education program, and sufficiently documented pursuant to the State Education … To SED: Review the recommended disallowances resulting from our audit and make the appropriate adjustments to …

Medicaid Program – Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims

… Inpatient care generally requires recipients to stay overnight in the hospital and be monitored by the health care …

Medicaid Program – Improper Fee-for-Service Pharmacy Payments for Recipients With Third-Party Health Insurance

… third-party health insurance (TPHI) for pharmacy services in addition to Medicaid (e.g., employer-based coverage, … to prevent TPHI overpayments from occurring. Beginning in 2023, pharmacy services for recipients enrolled in some managed care plans will be covered by FFS; therefore, …

DiNapoli: State is Slow in Disbursing Some Federal Relief Funds for Housing

… has been slow when it comes to using some federal relief funds earmarked to alleviate the state’s affordable housing … and its local program administrators, the distribution of funds has been delayed, putting some of the funding at risk. … crisis,” DiNapoli said. “We need every dollar available for housing needs in our state, particularly those that can …