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United HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center
… employees and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital care to outpatient surgical procedures and physician office visits. The New York State Department of …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-eastern-orange-ambulatory-surgery-centerUnited HealthCare – Overpayments for Services Provided by Long Island Spine Specialists
… Purpose To determine whether Long Island Spine Specialists, P.C. waived Empire Plan …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-spine-specialistsVillage of Nelliston - Payroll and Accounting Records (2018M-162)
… and recorded leave accruals and usage. Determine if the Clerk-Treasurer maintained timely and complete records and … properly manage the Village’s finances. Key Findings The Clerk did not withhold health insurance contributions totaling $5,392 from the Superintendent’s pay for the period March 2016 through February 2018. The …
https://www.osc.ny.gov/local-government/audits/village/2018/12/14/village-nelliston-payroll-and-accounting-records-2018m-162New York State Health Insurance Program – Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan
To determine whether CVS Caremark paid claims under the correct prescription drug plan
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/new-york-state-health-insurance-program-incorrect-payments-cvs-caremark-medicare-rx-drugDiNapoli: Former Clerk Treasurer for the Village of Speculator Charged With Larceny
… Bonnie Page was charged with grand larceny and corrupting the government for allegedly scamming the village out of $25,988 for health … by filing a complaint online at investigations@osc.ny.gov , or by mailing a complaint to: Office of the State …
https://www.osc.ny.gov/press/releases/2020/02/dinapoli-former-clerk-treasurer-village-speculator-charged-larcenyProgram Oversight and Monitoring of the Maximus Contract for the New York State of Health (Insurance Marketplace) Customer Service Center
… reviews. Key Findings The Department has an effective system to ensure that Maximus is complying with contract …
https://www.osc.ny.gov/state-agencies/audits/2016/06/16/program-oversight-and-monitoring-maximus-contract-new-york-state-health-insuranceEmpire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network
… special items according to the terms of its contract with Long Island Health Network and, if not, whether Empire BlueCross …
https://www.osc.ny.gov/state-agencies/audits/2019/11/29/empire-bluecross-improper-payments-special-items-billed-hospitals-within-long-island-healthCanton Central School District - Claims Audit Process (2018M-186)
… review the detailed, supporting documentation for all 17 health insurance claims paid during the audit period totaling over … should: Review detailed, supporting documentation for all health insurance claims. Audit and approve all scholarship …
https://www.osc.ny.gov/local-government/audits/school-district/2018/11/09/canton-central-school-district-claims-audit-process-2018m-186Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance (Follow-Up)
… made in our initial audit report, Managed Care Premium Payments for Recipients With Comprehensive … 2016-S-60 ). About the Program Mainstream managed care (the managed care program most Medicaid recipients …
https://www.osc.ny.gov/state-agencies/audits/2020/01/17/managed-care-premium-payments-recipients-comprehensive-third-party-insurance-followMedicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… administers New York’s Medicaid program. Many of the State’s Medicaid recipients receive their services through … payments made for services that should have been paid for by a recipient’s TPHI. During the audit period, HMS’ … for reasons that could be rectified, but follow-up actions by HMS to get payment on those claims were limited, and many …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsPlainview-Old Bethpage Central School District - Retiree Health Insurance (2018M-148)
Plainview-Old Bethpage Central School District - Retiree Health Insurance (2018M-148)
https://www.osc.ny.gov/files/local-government/audits/pdf/plainview-old-bethpage.pdfUnited HealthCare – Overpayments for Services Provided by Dr. John Gomes
… Purpose To determine whether the practice of Dr. John Gomes routinely waived Empire Plan members’ … City, an obstetrics and gynecology practice operated by Dr. John Gomes, located on Franklin Avenue in Garden City, …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-dr-john-gomesState Comptroller DiNapoli Releases Audits
… implement the audit’s six recommendations. New York City Administration for Children’s Services (ACS) and the New York …
https://www.osc.ny.gov/press/releases/2022/06/state-comptroller-dinapoli-releases-auditsState Comptroller DiNapoli Releases Audits
… Conditions (2021-S-27) Flooding remains a serious issue for the City and the Metropolitan Transportation Agency’s … in the initial audit report, implementing a new procedure for monitoring and reviewing training records. Of the initial … The New York Freedom of Information Law (FOIL) provides for public access to government records. Under FOIL, …
https://www.osc.ny.gov/press/releases/2023/10/state-comptroller-dinapoli-releases-auditsComptroller DiNapoli Releases School Audits
… employees’ personal internet browsing and their use of social media on district computers. Officials also did not provide … interfund transfers totaling $1.2 million to be used for a capital project which had not yet been approved by …
https://www.osc.ny.gov/press/releases/2019/12/comptroller-dinapoli-releases-school-auditsFederal Spending by Major Funding Streams and Functions – Federal Funding and New York
… funding is received by New York State through grants for a range of purposes, including health care, … transportation, public assistance, education, employment and training, and emergency response and recovery. The … Low Income Home Energy Assistance Program and meals for school children. Additional large grants include Pell Grant …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/federal-spending-major-funding-streams-and-functionsEmpire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… Background The New York State Health Insurance Program (NYSHIP) provides health coverage to active and retired State, …
https://www.osc.ny.gov/state-agencies/audits/2013/05/09/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughState Comptroller DiNapoli Releases Municipal & School Audits
… (Suffolk County) District officials did not ensure that funds collected from all recreational and educational …
https://www.osc.ny.gov/press/releases/2024/08/state-comptroller-dinapoli-releases-municipal-school-auditsImproper Medicaid Payments During Permissible Overlapping Medicaid and Essential Plan Coverage (Follow-Up)
… and the Essential Plan, both of which provide health care services to individuals who are economically disadvantaged. … DOH deployed a new process in its claims processing system to recognize certain Essential Plan coverage as liable …
https://www.osc.ny.gov/state-agencies/audits/2025/06/04/improper-medicaid-payments-during-permissible-overlapping-medicaid-and-essential-planSherrill City School District – Reserve Funds (2017M-247)
… Purpose of Audit The purpose of our audit was to determine whether the Board properly established reserve … used. Use the surplus funds in the tax certiorari reserve to fund one-time expenditures, fund needed reserves, pay off …
https://www.osc.ny.gov/local-government/audits/school-district/2018/02/02/sherrill-city-school-district-reserve-funds-2017m-247