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Medicaid Program – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… Purpose To determine whether Davis Ethical Pharmacy (Davis Ethical) inappropriately billed Medicaid for … Program provides prescription drug coverage for enrollees. Davis Ethical is an independently owned pharmacy located in … To determine whether Davis Ethical Pharmacy Davis Ethical inappropriately billed …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/medicaid-program-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyNew York State Dental Program – Payments for Scaling and Root Planing Procedures (Follow-Up)
… dental claims on behalf of the State. Emblem Health is the parent company of GHI and HIP Health Plan of New York, … in nature. Instead, they are used when periodontal disease is indicated. The objective of the treatment is to help shrink periodontal pockets, heal gum tissue, and …
https://www.osc.ny.gov/state-agencies/audits/2013/11/12/new-york-state-dental-program-payments-scaling-and-root-planing-procedures-followNew York Center for Child Development, Inc. – Compliance With the Reimbursable Cost Manual
… Purpose To determine whether the costs reported by the New York … (CFRs) were reasonable, necessary, directly related to the special education program, and sufficiently documented pursuant to the State Education Department’s (SED) Reimbursable Cost … To determine whether the costs reported by the New York …
https://www.osc.ny.gov/state-agencies/audits/2016/12/30/new-york-center-child-development-inc-compliance-reimbursable-cost-manualMedicaid Program – Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare
… 1, 2015 through July 31, 2019. About the Program Hospice is a coordinated program of home and/or inpatient care that … and Medicare (referred to as dual-eligibles), Medicare is the primary payer for Medicare-covered hospice services, while Medicaid is the payer of last resort. Several entities are responsible …
https://www.osc.ny.gov/state-agencies/audits/2020/12/28/medicaid-program-improper-medicaid-payments-individuals-receiving-hospice-services-coveredImproper Managed Care Premium Payments for Recipients With Duplicate Client Identification Numbers (Follow-Up)
… audit report, Improper Managed Care Premium Payments for Recipients With Duplicate Client Identification Numbers (Report 2018-S-24 ). … the State’s Medicaid program. Each individual who applies for Medicaid benefits is assigned a Client Identification … audit report Improper Managed Care Premium Payments for Recipients With Duplicate Client Identification Numbers …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/improper-managed-care-premium-payments-recipients-duplicate-client-identification-numbersSelected Aspects of Leasing Practices for Real Estate Services Department and Port Commerce
… Liberty. The PANYNJ was created to promote and protect the commerce of the Port District and to undertake port and … that reflect its major business segments, including: Port Commerce – operates the Port of New York and New Jersey, the … we examined at market rate. We found that, for Port Commerce, seven out of nine leases had various segments of …
https://www.osc.ny.gov/state-agencies/audits/2019/05/16/selected-aspects-leasing-practices-real-estate-services-department-and-port-commerceMedicaid Program – Improper Managed Care Payments for Recipients With Duplicate Client Identification Numbers
… require. Each individual who applies for Medicaid benefits is assigned a Client Identification Number (CIN), a unique … eligibility and enrollment information originates, it is transmitted to the Department’s eMedNY claims processing … to make appropriate claim payments. When an individual is assigned duplicate CINs, each with its own record of …
https://www.osc.ny.gov/state-agencies/audits/2019/07/29/medicaid-program-improper-managed-care-payments-recipients-duplicate-client-identificationUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers (Follow-Up)
… Objective To determine the extent of implementation of the two … facilities focused on providing same-day surgical care. To help control costs, certain in-network ASCs have contract … provisions that require all anesthesia services provided to Empire Plan members at their facilities to be performed by …
https://www.osc.ny.gov/state-agencies/audits/2019/11/18/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryMount Sinai Fire District - Financial Condition and Price Quotations for Purchases (2019M-83)
… [read complete report - pdf] Audit Objective Determine if the Board and District officials effectively managed the District’s financial condition. Determine if the District is seeking competition for purchases that are … Determine if the Board and District officials effectively managed the …
https://www.osc.ny.gov/local-government/audits/fire-district/2019/08/23/mount-sinai-fire-district-financial-condition-and-price-quotationsUniversity Preparatory Charter School for Young Men – Student Enrollment and Billing (2013M-292)
… The University Preparatory Charter School for Young Men is located in the City of Rochester and is governed by a 10-member Board. The School’s budgeted …
https://www.osc.ny.gov/local-government/audits/charter-school/2014/01/24/university-preparatory-charter-school-young-men-student-enrollment-andTown of Charlton – Internal Controls Over Billed Receivables for Water Operations (2014M-28)
… through August 31, 2013. Background The Town of Charlton is located in Saratoga County and is governed by an elected five-member Town Board and has a …
https://www.osc.ny.gov/local-government/audits/town/2014/05/09/town-charlton-internal-controls-over-billed-receivables-water-operations-2014m-28DiNapoli Calls for NYC to Bolster Reserves as Economy Rebounds Amid Rising Spending
… to $1 billion. It also maintained a general reserve of $300 million in FY 2022. In total, the city’s reserves stand …
https://www.osc.ny.gov/press/releases/2021/08/dinapoli-calls-nyc-bolster-reserves-economy-rebounds-amid-rising-spendingDiNapoli: Stable Government Funding Needed for NYC Health + Hospitals to Provide Essential Care
… most vulnerable, puts the system under constant financial pressure. The pandemic has only added to that challenge,” … and attracting and keeping patients. The pandemic put more pressure than ever on H+H and strained physical and staff … $590 million in FEMA reimbursement have created financial pressure. While these funds have received preliminary …
https://www.osc.ny.gov/press/releases/2021/09/dinapoli-stable-government-funding-needed-nyc-health-hospitals-provide-essential-careDiNapoli: Unrestricted State Aid for Local Governments Failed to Keep Up With Inflation
… Unrestricted state aid for cities, towns and villages has remained flat or declined … York State Comptroller Thomas P. DiNapoli. When adjusted for inflation, unrestricted aid to local governments has … enacted. Because this aid can be used by municipalities for any governmental purpose, it is an important revenue …
https://www.osc.ny.gov/press/releases/2022/02/dinapoli-unrestricted-state-aid-local-governments-failed-keep-inflationDiNapoli: State Needs To Do More for Growing Mental Health Crisis in Schools
… Too many of New York school districts’ mental health teams are understaffed, with too few available services and … of New York City entered the pandemic with mental health teams that were far short of nationally recommended … Too many of New York school districts mental health teams are understaffed with too few available services and …
https://www.osc.ny.gov/press/releases/2022/04/dinapoli-state-needs-do-more-growing-mental-health-crisis-schoolsDiNapoli: MTA Outlook Shows Growing Need for New Funding as Budget Gaps Widen
… billion in 2025 and grow in the outyears, according to a report on MTA’s financial outlook released today by New York … is clearer. Gaps are forecast at $2.5 billion in 2025 and 2026 as spending outpaces inflation projections, but could be … in the future, including the deferral of debt service payments. The MTA should specify and increase planned …
https://www.osc.ny.gov/press/releases/2022/10/dinapoli-mta-outlook-shows-growing-need-new-funding-budget-gaps-widenDiNapoli: NYC Emergency Management Failing to Ensure the City is Prepared for Disasters
… a matter of if, but when, another massive storm like Sandy will hit New York City, potentially crippling its …
https://www.osc.ny.gov/press/releases/2022/10/dinapoli-nyc-emergency-management-failing-ensure-city-prepared-disastersNY State Comptroller DiNapoli Announces Responsible Workforce Management Policy for Private Equity Investments
… New York State Comptroller Thomas P. DiNapoli, trustee of the New York State Common Retirement Fund (Fund), today announced … Responsible Workforce Management Policy and Principles The New York State Common Retirement Fund is one of the largest … New York State Comptroller Thomas P DiNapoli trustee of the …
https://www.osc.ny.gov/press/releases/2024/04/ny-state-comptroller-dinapoli-announces-responsible-workforce-management-policy-private-equityDiNapoli: Improved Planning Needed for New York To Achieve Its Clean Energy Goals
… Protection Act’s (Climate Act) targets, which seek 70% renewably sourced electricity by 2030 and net-zero … wrong calculations to determine if the state could reach 70% renewably sourced electricity by 2030. The PSC did not … to be up and running, as a 2030 deadline looms to achieve 70% renewably sourced electricity. Renewable Energy Contracts …
https://www.osc.ny.gov/press/releases/2024/07/dinapoli-improved-planning-needed-new-york-achieve-its-clean-energy-goalsDiNapoli: State Paid $14.5 Billion for Medicaid Home Care Services That Lacked Verification
… can submit information about their home visit using a phone app, landline phone, or fixed object placed in the home. During the audit …
https://www.osc.ny.gov/press/releases/2024/11/dinapoli-state-paid-145-billion-medicaid-home-care-services-lacked-verification