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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 …

Special 25-Year Plan for Institutional Safety Officers (Sections 89-t and 604(q))

… (Return to Top) VO1873 (Rev. 7/11) © 2011, New York State and Local Retirement System  (Return to Top) … Information for members about special 25 year retirement plan providing an alternative retirement benefit for institutional safety officers and safety and secur …

United HealthCare – Overpayments for Services Provided by Eastern Orange Ambulatory Surgery Center

… LLC waived Empire Plan members’ out-of-pocket costs, and if so, to quantify the overpayments made by United HealthCare resulting from … it will result in United making an excessive payment on the claim. Our audit focused on claims submitted to United …

Medicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits

… whether the Department of Health paid pharmacy providers for controlled substances in compliance with the New York … risk of drugs ordered in this manner being diverted for inappropriate or unauthorized use. The supply limits that … overpaid pharmacies $1,183,601 for 13,705 fee-for-service claims, in which quantities of controlled substances exceeded …

Special Plan for Suffolk County Park Police Officers (Sections 89-r and 603(n))

… (Return to Top) (Return to Top) (Return to Top) (Return to Top) VO1855 (Rev. 6/12) © 2012, New York State and Local …

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 …

Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber

… well as the rules and policies set forth by the Department of Health (Department) and the State Education Department. … 2008 through December 31, 2012. Note : During the course of the audit, the audit fieldwork was temporarily suspended … with a review by other external oversight authorities of some of the matters addressed in this report. Subsequent …

Medicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease

… Purpose To determine whether the Department of Health took sufficient steps to control the Medicaid costs of recipients diagnosed with end stage … who were eligible for, but not enrolled in, Medicare. The audit covered the period January 1, 2010 through December …

Oversight of Hotels and Motels Used for Homeless and Mixed-Use Temporary Residency

… (DOH) are adequately ensuring that hotels and motels used for homeless and mixed-use temporary residency are properly … portion of their homeless populations. In fact, for many rural counties, hotels and motels are the only … shelter facility. OTDA has assigned responsibility for the inspection of hotels and motels housing the homeless …

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 …

Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)

… Purpose To determine the extent of implementation of the three … 13, 2011, Medicaid made improper payments totaling $94,460 to Davis Ethical Pharmacy. Based on information obtained from … that patients actually picked-up the drugs billed to Medicaid. Moreover, as a result of our audit, we concluded …

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 …

Medicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care

… disadvantaged and/or have special health care needs. In general, the Medicaid program pays medical providers … a monthly premium for every Medicaid recipient enrolled in the MCO, and the MCO arranges for the provision of … was no longer appropriate for recipients enrolled in managed care. As of December 2013, approximately 4 million …

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 …