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Medicaid Program – Managed Care Payments for Services Not Coordinated Through Recipient Restriction Program Providers
… Objective To determine whether the Department of Health (DOH) provided adequate oversight to ensure managed care recipients in the Recipient … To determine whether the Department of Health DOH provided …
https://www.osc.ny.gov/state-agencies/audits/2024/11/26/medicaid-program-managed-care-payments-services-not-coordinated-through-recipientHebrew Institute for the Deaf and Exceptional Children – Compliance With the Reimbursable Cost Manual
… and half-day Special Class (SC) and Special Class in an Integrated Setting (SCIS) preschool special education … These ineligible costs included $624,868 in personal service costs and $149,254 in other than personal service costs, as follows: $194,438 in lump sum bonuses that …
https://www.osc.ny.gov/state-agencies/audits/2016/11/22/hebrew-institute-deaf-and-exceptional-children-compliance-reimbursable-cost-manualMedicaid Program – Questionable Payments for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician
… Medicaid managed care plans) paid Dr. Ahmad $1,039,404 for 24,695 office visits. During this period, the Medicaid program also paid approximately $15 million for medications Dr. Ahmad prescribed in connection with those … to support a physician’s Medicaid claim. During the course of this audit, our fieldwork was temporarily suspended …
https://www.osc.ny.gov/state-agencies/audits/2015/09/18/medicaid-program-questionable-payments-practitioner-services-and-pharmacy-claims-pertainingMedicaid Program – Excessive Medicaid Payments to Federally Qualified Health Centers for Group Therapy Services
… rates. With approval from the federal Centers for Medicare and Medicaid Services, the Department amended the … of Health: Overpayments for Services Also Covered by Medicare Part B (2012-S-27) Department of Health: Medicaid …
https://www.osc.ny.gov/state-agencies/audits/2014/11/18/medicaid-program-excessive-medicaid-payments-federally-qualified-health-centers-groupMedicaid Program – Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns
… Purpose To determine if Medicaid overpaid managed care organizations … reimburse directly for providing services. In addition to monthly capitation payments, MCOs receive supplemental … Newborn Capitation Payment” (commonly referred to as a kick payment) for the inpatient birthing costs of …
https://www.osc.ny.gov/state-agencies/audits/2014/10/02/medicaid-program-overpayments-managed-care-organizations-and-hospitals-low-birth-weightUnited HealthCare – Overpayments for Services Provided by Hudson Valley Bone and Joint Surgeons, LLP
… Members pay a nominal co-payment to the participating provider for the services rendered. Members may also choose … requirements, when United processes a non-participating provider’s claims, it is with the understanding that Empire … cost-sharing obligations. However, if a non-participating provider does not collect (i.e., waives) the member’s …
https://www.osc.ny.gov/state-agencies/audits/2016/09/08/united-healthcare-overpayments-services-provided-hudson-valley-bone-and-joint-surgeons-llpUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
… Department of Financial Services. On December 10, 2015, William Davis, former owner Davis Ethical Pharmacy, pleaded … in the Second Degree in Nassau County District Court. William Davis was sentenced on February 9, 2016 and made … we did not test, and formally assess the conduct of William Davis. Key Finding United officials made progress …
https://www.osc.ny.gov/state-agencies/audits/2016/02/18/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyStatewide Compliance With Administrative Requirements for Retail Liquor License Approvals, Renewals, and Enforcement Actions
… Matters pertaining to noise complaints related to liquor license holders in New York City were addressed separately, … fine on the licensee and/or suspend, cancel, or revoke the license. The Authority has a total of 96 types of licenses … types of permits. Our audit focused on the largest retail license types (On Premises Liquor, Grocery Store Beer, and …
https://www.osc.ny.gov/state-agencies/audits/2017/06/21/statewide-compliance-administrative-requirements-retail-liquor-license-approvals-renewalsImproper Medicaid Payments Involving Fee-for-Service Claims for Recipients With Multiple Client Identification Numbers (Follow-Up)
… Objective To determine the extent of implementation of the six … marketplace). Multiple eligibility systems are used to process Medicaid applications and enrollments. Each … Medicaid recipients may have more than one CIN assigned to them during the time they are in receipt of benefits; …
https://www.osc.ny.gov/state-agencies/audits/2022/09/08/improper-medicaid-payments-involving-fee-service-claims-recipients-multiple-clientUnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Follow-Up)
… Objective To determine the extent of implementation of the four … (Civil Service), provides health insurance coverage to over 1.2 million active and retired State, local … UnitedHealthcare Insurance Company of New York (United) to administer the Empire Plan’s medical/surgical benefits. …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/unitedhealthcare-insurance-company-new-york-improper-payments-acupuncture-and-acupunctureHarrisville Central School District – Transportation State Aid and Debt for Bus Purchases (2020M-48)
… new bus acquisitions resulting in a potential revenue loss of $477,200. During our audit, the Business Manager prepared and submitted State aid forms for three of these buses. The District unnecessarily borrowed more than …
https://www.osc.ny.gov/local-government/audits/school-district/2020/07/02/harrisville-central-school-district-transportation-state-aid-and-debt-busDiNapoli: MTA Needs to Refocus Attention on Overdue Upgrades and Preparations for Extreme Weather
… Comptroller Thomas P. DiNapoli’s latest report . “The MTA is getting a large infusion of federal infrastructure funds, … to reassess and focus its priorities to get money where it is most needed to restore the system and bring riders back. … assessment, covering 2015-2034, was published in 2013 and is overdue for an update. The MTA is now required by state …
https://www.osc.ny.gov/press/releases/2021/12/dinapoli-mta-needs-refocus-attention-overdue-upgrades-and-preparations-extreme-weatherDiNapoli: School District and Big City Tax Levy Cap at 2% for Second Straight Year
… will be capped at 2%, the same as last year, according to data released today by State Comptroller Thomas P. DiNapoli. The tax cap, which first applied to local governments and school districts in 2012, limits annual tax levy increases to the lesser of the rate of inflation or 2% with certain …
https://www.osc.ny.gov/press/releases/2023/01/dinapoli-school-district-and-big-city-tax-levy-cap-2-percent-second-straight-yearThe North Country Is Among the Top Regions in the State for Agricultural Sales
… engine for their communities and an essential part of our food supply system. This is especially true in the North … producing region in the state. Access to fresh, healthy food adds to the quality of life in the state, but this local food supply was put to the test during the pandemic, and …
https://www.osc.ny.gov/press/releases/2024/11/dinapoli-agriculture-report-reveals-economic-growth-and-challenges-facing-new-york-farms-north-countryDiNapoli Report Analyzes Regional Trends in Education for School Districts Outside New York City
… A new report by New York State Comptroller Thomas P. DiNapoli shows the … financial information from nine separate regions outside New York City. “School districts must navigate a complex set … A new report by New York State Comptroller Thomas P DiNapoli shows the …
https://www.osc.ny.gov/press/releases/2020/03/dinapoli-report-analyzes-regional-trends-education-school-districts-outside-new-york-cityDiNapoli Op-Ed in Democrat & Chronicle Calls for Swift Action to Address Growing Food Insecurity
… Thomas P. DiNapoli highlighting the urgent need to help the growing number of New Yorkers going hungry in the … the COVID-19 pandemic. The full op-ed is below: The need to combat hunger is clear and urgent The COVID-19 pandemic has halted vast areas of economic activity, led to skyrocketing unemployment, and pushed families to new …
https://www.osc.ny.gov/press/releases/2020/07/dinapoli-op-ed-democrat-chronicle-calls-swift-action-address-growing-food-insecurityDiNapoli: Some Bright Spots for NYC Finances in FY21, but Long-Term Challenges Looming
… 2021 because of better-than-projected revenues from income and corporate taxes, debt service savings from lower interest rates and a deferral of labor costs to FY 2022, but the city will … by the pandemic, but strength in the securities industry and other sectors have boosted personal income and business …
https://www.osc.ny.gov/press/releases/2021/02/dinapoli-some-bright-spots-nyc-finances-fy21-long-term-challenges-loomingDiNapoli: Lack of Oversight Delayed Access to Emergency Home Repairs for Elderly New Yorkers
… program contributed to delays in urgent home repairs for seniors. The audit found the agency needs to do more to … program. “The RESTORE program has been a vital resource for seniors across our state whose homes may be at risk if … program contributed to delays in urgent home repairs for seniors …
https://www.osc.ny.gov/press/releases/2021/07/dinapoli-lack-oversight-delayed-access-emergency-home-repairs-elderly-new-yorkersDiNapoli: Many NYC Senior Citizens Remaining Too Long on DFTA Wait Lists for Services
… Too many seniors are waiting months on the New York City Department for the Aging’s (DFTA) client wait lists to get critical … to strengthen its oversight of service providers to ensure seniors are getting the support they depend on in a timely … Too many seniors are waiting months on the New York City Department …
https://www.osc.ny.gov/press/releases/2023/07/dinapoli-many-nyc-senior-citizens-remaining-too-long-dfta-wait-lists-servicesDiNapoli: Audit Highlights Opportunities for Improvement of Apprenticeship Programs to Enhance Value and Reach
… workers who power it.” “Apprenticeship programs are the gold standard for developing a safe, skilled and diverse …
https://www.osc.ny.gov/press/releases/2025/07/dinapoli-audit-highlights-opportunities-for-improvement-of-apprenticeship-programs-to-enhance-value-and-reach