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Town of Babylon – Financial Condition and Internal Controls Over Selected Town Operations (2013M-115)
… of our audit was to examine the Town’s financial condition and internal controls over selected financial operations for … which comprises five elected members: the Town Supervisor and four Board members. The Town’s major operating funds’ … $6.1 million to a deficit of $10.5 million. Between 2008 and 2011, the residential garbage district fund made 17 cash …
https://www.osc.ny.gov/local-government/audits/town/2013/11/22/town-babylon-financial-condition-and-internal-controls-over-selected-town-operationsMedicaid Program – Managed Care Premium Payments for Recipients With Comprehensive Third-Party Insurance
… whether the Department of Health (Department) made Medicaid mainstream managed care premium payments on behalf of individuals who … January 1, 2012 to September 1, 2017. Background The Medicaid program is a federal, state, and locally funded … To determine whether the Department of Health made Medicaid mainstream managed care premium payments on behalf …
https://www.osc.ny.gov/state-agencies/audits/2018/06/13/medicaid-program-managed-care-premium-payments-recipients-comprehensive-third-partyImproper Medicaid Payments During Permissible Overlapping Medicaid and Essential Plan Coverage (Follow-Up)
… (Report 2022-S-35 ). About the Program The Department of Health (DOH) administers the State’s Medicaid program and the Essential Plan, both of which provide health care services to individuals who are economically … of overlapping coverage. The Essential Plan should be the primary payer and Medicaid, as secondary payer, should pay …
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 … The Sherrill City School District is located in the Cities of Rome and Sherrill and the Towns of Kirkland, Verona, …
https://www.osc.ny.gov/local-government/audits/school-district/2018/02/02/sherrill-city-school-district-reserve-funds-2017m-247CUNY Bulletin No. CU-719
… The purpose of this bulletin is to notify agencies of new voluntary deduction codes for City University of New York (CUNY) Health Insurance. Affected Employees CUNY …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-719-new-voluntary-deductions-codes-cuny-health-insuranceMedicaid Program – Medicaid Claims Processing Activity April 1, 2015 Through September 30, 2015
… ensured that Medicaid claims were submitted by approved providers, were processed in accordance with Medicaid … requirements, and resulted in correct payments to the providers. The audit covered the period April 1, 2015 through … computer system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible …
https://www.osc.ny.gov/state-agencies/audits/2016/08/09/medicaid-program-medicaid-claims-processing-activity-april-1-2015-through-september-30-2015DiNapoli: MetroPlus Enrollment Reached a Record High Over the Course of the Pandemic
… MetroPlus enrollment reached a record high of 670,915 members, an increase of 159,284 (31%), according to a report … of H+H is impacted by MetroPlus’s membership levels and members use of H+H health services. The amount of MetroPlus … robust managed care and high-quality services to its members, while implementing effective strategies to retain …
https://www.osc.ny.gov/press/releases/2022/09/dinapoli-metroplus-enrollment-reached-record-high-over-course-pandemicEmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits
… which plan pays the full benefits first (primary payer) and which plan pays remaining expenses second (secondary payer). This is necessary to prevent duplicate payment of … plans), making Emblem both the primary and secondary payer. For instance, in the case of a married couple where …
https://www.osc.ny.gov/state-agencies/audits/2024/01/08/emblemhealth-plan-inc-overpayments-services-requiring-coordination-benefitsMedicaid – Federal Funding and New York
… program for low-income adults and children. Each state administers its own Medicaid program within federal … guidelines, and it is jointly funded by the federal and state governments. New York State requires localities to … access to information and assistance for older adults on long term services and supports. In the City, this program …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/medicaid-nycDiNapoli: Contractor Failed to Turn Over $1.5 Million in Prescription Drug Rebates to NYS
… Plan (NYSHIP) failed to turn over nearly $1.5 million in rebates to the state over a four-year period, according to … Express Scripts Holding Company took over those duties in 2012. DiNapoli’s auditors found that on a quarterly basis, … Scripts invoiced drug manufacturers for rebates and, in accordance with its subcontract with United, made …
https://www.osc.ny.gov/press/releases/2016/11/dinapoli-contractor-failed-turn-over-15-million-prescription-drug-rebates-nysEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012
… whether Empire BlueCross BlueShield (Empire) paid claims for special items according to the provisions of the … portion of the Empire Plan (Plan), which includes coverage for inpatient and outpatient hospital services. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/12/13/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughMedicaid Program – Recovering Managed Care Payments for Inpatient Services on Behalf of Recipients With Third-Party Health Insurance
… Medicaid overpayments for inpatient services on behalf of managed care recipients who had third-party health … 2017 through August 2021. About the Program The Department of Health (Department) administers New York’s Medicaid program. Many of the State’s Medicaid recipients receive their services …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/medicaid-program-recovering-managed-care-payments-inpatient-services-behalf-recipientsMedicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
… system processes Medicaid claims submitted by providers for services rendered to Medicaid-eligible recipients, and it generates payments to reimburse the providers for their claims. During the six-month period ended September … Medicaid payments, including: $1,822,467 in payments for pharmacy claims that posed patient safety concerns or …
https://www.osc.ny.gov/state-agencies/audits/2015/02/05/medicaid-program-medicaid-claims-processing-activity-april-1-2013-through-september-30-2013Town of Shandaken – Employee Compensation and Benefits (2017M-289)
… employees and whether amounts withheld and paid for employee benefits were accurate for the period January 1, … the audit period. Also, Town officials did not withhold employee contributions for health insurance coverage. As a … and seven employees were overcharged by $724. A former employee who retired in 2017 received, used and was paid for …
https://www.osc.ny.gov/local-government/audits/town/2018/04/13/town-shandaken-employee-compensation-and-benefits-2017m-289New York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… of the five recommendations included in our initial audit report, Payments by Empire BlueCross for Hospital Services for Ineligible Members (Report 2019-S-32 ). About the Program The New York State … of the five recommendations included in our initial audit report Payments by Empire BlueCross for Hospital Services for …
https://www.osc.ny.gov/state-agencies/audits/2021/12/27/new-york-state-health-insurance-program-payments-empire-bluecross-hospital-servicesJoin Our Investment Team
… Salary and Benefits We offer competitive base salaries and extensive benefits packages, which include: … We offer competitive base salaries and extensive benefits packages which include …
https://www.osc.ny.gov/common-retirement-fund/employmentState Comptroller DiNapoli Releases Audits
… Drugs (Follow-Up) (2024-F-34) The New York State Health Insurance Program (NYSHIP) is administered by the … Service (Civil Service). The Empire Plan is the primary health insurance plan for NYSHIP, and Civil Service contracts … (Anthem), formerly Empire BlueCross, to administer the Hospital Program of the Empire Plan and to process and pay …
https://www.osc.ny.gov/press/releases/2025/06/state-comptroller-dinapoli-releases-auditsMedicaid Program – Improper Overlapping Medicaid and Essential Plan Enrollments
… organized under the Department where individuals can apply for and enroll in health insurance plans, including …
https://www.osc.ny.gov/state-agencies/audits/2022/10/11/medicaid-program-improper-overlapping-medicaid-and-essential-plan-enrollmentsState Contract and Payment Actions in December
… Civil Service $6 billion for HMO Health Benefits for the New York State Health Insurance Program (NYSHIP) including … Physician’s Health Plan Inc., $1.4 billion with HealthNow New York Inc., $1 billion with Independent Health Association … of Environmental Conservation $16.2 million with the New England Interstate Water Pollution Control Commission for …
https://www.osc.ny.gov/press/releases/2021/02/state-contract-and-payment-actions-decemberState Contract and Payment Actions in September
… In September, the Office of the State Comptroller approved 1,803 contracts for state … Open Book New York . Major Contracts Approved Department of Corrections and Community Supervision $35.2 million with … Services Inc. for registered nursing services. Department of Environmental Conservation $17 million with Tahawus Trails …
https://www.osc.ny.gov/press/releases/2023/11/state-contract-and-payment-actions-september