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Medicaid Program – Recovering Managed Care Overpayments for Pharmacy Services on Behalf of Recipients With Third-Party Health Insurance
… on behalf of managed care recipients who had third-party health insurance were appropriately recovered. The audit covered the …
https://www.osc.ny.gov/state-agencies/audits/2022/07/13/medicaid-program-recovering-managed-care-overpayments-pharmacy-services-behalf-recipientsSelected Payments for Special Items Made to St. Peter's Hospital from January 1, 2011 through March 31, 2011
… Plan. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … $4,836 from St. Peter’s for the overpayments we identified in this audit. Develop and implement the controls necessary …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to Mount Sinai Hospital from January 1, 2011 through March 31, 2011
… Purpose To determine if BlueCross BlueShield's (Empire's) payments to Mount Sinai Hospital (Mount Sinai) for special items were made according to the provisions of the agreement between Empire and Mount Sinai. Background …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-mount-sinai-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to Albany Medical Center from January 1, 2011 through March 31, 2011
… for special items were made according to the provisions of the agreement between Empire and AMC. Background The New … primary health benefits plan for NYSHIP. The Department of Civil Service contracts with Empire to administer the hospitalization portion of the Plan. Empire processes Plan claims for hospital …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-albany-medical-center-january-1-2011-through-march-31Comptroller DiNapoli, Manhattan D.A. Bragg Announce Guilty Plea of Former NYU Director of Finance for Major Fraud
… created, using some of the funds for NYU payments and employee reimbursements, but keeping more than $660,000 to …
https://www.osc.ny.gov/press/releases/2024/02/comptroller-dinapoli-manhattan-da-bragg-announce-guilty-plea-former-nyu-director-finance-major-fraudDiNapoli: Former Medical Office Manager Arrested for Scheme to Defraud the New York State Health Insurance Plan
… investigation between Comptroller DiNapoli, Ulster County District Attorney Clegg, and the FBI Hudson Valley White … to my long-standing partnerships with Ulster County District Attorney Clegg and the Federal Bureau of …
https://www.osc.ny.gov/press/releases/2023/09/dinapoli-former-medical-office-manager-arrested-scheme-defraud-new-york-state-health-insurance-planDiNapoli: Former Throop Supervisor Pays Full Restitution After Pleading Guilty to Felony for Stealing $11,000 from Town
… The former Town of Throop Supervisor, William Tarby, paid full restitution as part of his … James, and the New York State Police announced today. William Tarby pleaded guilty to grand larceny and official …
https://www.osc.ny.gov/press/releases/2024/02/dinapoli-former-throop-supervisor-pays-full-restitution-after-pleading-guilty-felony-stealing-11000Medicaid Program – Improper Payments for Recipients No Longer Enrolled in Managed Long Term Care Partial Capitation Plans
… plans for recipients who were no longer enrolled in these plans. The audit covered the period January 1, 2010 … problem or disability. Generally, recipients enrolled in these Plans need home care, adult day health care, or … capitation payment for every Medicaid recipient enrolled in a Plan, and the Plan arranges for the provision of …
https://www.osc.ny.gov/state-agencies/audits/2016/03/30/medicaid-program-improper-payments-recipients-no-longer-enrolled-managed-long-term-careSelected Payments for Special Items Made to St. Mary's Hospital from January 1, 2011 through March 31, 2011
… to the provisions of the agreement between Empire and St. Mary’s. Background The New York State Health … (NYSHIP) provides health insurance coverage to active and retired State, participating local government and school district employees and their dependents. The …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011Identifying, Reporting, and Providing Services for Youth at Risk of Sexual Human Trafficking in New York City
… report on, and provide services for victims of child sex trafficking and those at risk of child sex trafficking. The audit covered the period from January … crimes. In 2014, the U.S. Congress enacted the Preventing Sex Trafficking and Strengthening Families Act, which …
https://www.osc.ny.gov/state-agencies/audits/2022/06/06/identifying-reporting-and-providing-services-youth-risk-sexual-human-trafficking-new-yorkDiNapoli Op-Ed in the NY Daily News Cautions NYC Leaders to Prepare for Challenging Fiscal Times Ahead
… Thomas P. DiNapoli today warning New York City’s leaders to safeguard the city’s finances against the challenges that … is below: In the last 20 years, New York City has had to recover from a terrorist attack, a recession fueled by a … the city will face uncertainty in the months and years to come. Predicting the city’s fiscal future is problematic. …
https://www.osc.ny.gov/press/releases/2021/09/dinapoli-op-ed-ny-daily-news-cautions-nyc-leaders-prepare-challenging-fiscal-times-aheadInappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus (Follow-Up)
… Objective To determine the extent of implementation of the five recommendations made in our initial audit report, … was eliminated effective January 1, 2015 and the majority of FHP enrollees transitioned to the Medicaid program. …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/inappropriate-premium-payments-recipients-no-longer-enrolled-mainstream-managed-care-andSelected Aspects of Leasing Practices for Real Estate Department, Aviation, World Trade Center, and Leasing of Properties
… Objectives To determine whether the Port Authority of New York and New Jersey (PANYNJ) collected all revenues due and identified …
https://www.osc.ny.gov/state-agencies/audits/2021/05/04/selected-aspects-leasing-practices-real-estate-department-aviation-world-trade-center-andDiNapoli: 33.55 Percent Annual Investment Return for New York State Pension Fund Is Largest in Its History
… State Comptroller Thomas P. DiNapoli today announced that the New York State Common Retirement Fund’s (Fund) estimated … Fund’s value to an estimated $254.8 billion. “The state pension fund rode the market rebound from the depths of the … percent). The Fund’s long-term expected rate of return is 6.8 percent. Historic Fund Returns and Value Fund’s value …
https://www.osc.ny.gov/press/releases/2021/05/dinapoli-33-point-55-percent-annual-investment-return-new-york-state-pension-fund-largest-its-historySelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… Purpose To determine if BlueCross BlueShield’s (Empire’s) payments to Arden Hill Hospital (Arden Hill) for special items were made according to the provisions of the agreement between Empire and Arden Hill. Background …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-arden-hill-hospital-january-1-2011-through-march-31Medicaid Program – Improper Medicaid Payments for Claims Not in Compliance With Ordering, Prescribing, Referring, and Attending Requirements
… Objective To determine whether the Department of Health (Department) paid for claims in violation of federal and State regulations that require an appropriate National …
https://www.osc.ny.gov/state-agencies/audits/2021/08/17/medicaid-program-improper-medicaid-payments-claims-not-compliance-ordering-prescribingDiNapoli: Former Tax Collector Accused of Pocketing $88,000 for Car Loans, Amazon Purchases, Food and Other Expenses
… State Comptroller Thomas P. DiNapoli today announced the arrest of Jennifer Colucci, 41, of Hopewell Junction, N.Y., … for the use of the town of Beekman and its schools. The arrest was the result of a joint investigation between … for partnering with us against public corruption.” “This arrest should serve as a reminder that those who choose to …
https://www.osc.ny.gov/press/releases/2021/03/dinapoli-former-tax-collector-accused-pocketing-88000-car-loans-amazon-purchases-food-and-otherMedicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
… of Health (Department) adopted the APG methodology in an effort to pay providers more accurately for their … condition and complexity of service. The Department phased in the APG methodology beginning with hospital outpatient … on December 1, 2008. The methodology was implemented in freestanding diagnostic and treatment centers and …
https://www.osc.ny.gov/state-agencies/audits/2015/06/29/medicaid-program-ambulatory-patient-groups-payments-duplicate-claims-and-services-excessDiNapoli: Queens Woman Charged With Stealing Nearly $85,000 in NYS Pension Payments Meant for Her Deceased Father
… for allegedly stealing nearly $85,000 in New York state pension payments meant for her deceased father, State … for her own gain,” DiNapoli said. “Thanks to the work of my office, Albany County District Attorney David Soares and … or account holder, transferred $67,423 through an online payment platform from the account to herself. Another …
https://www.osc.ny.gov/press/releases/2024/05/dinapoli-queens-woman-charged-stealing-nearly-85000-nys-pension-payments-meant-her-deceased-fatherDiNapoli: Queens Woman Pleads Guilty to Stealing $85,000 in NYS Pension Payments Meant for Her Deceased Father
… larceny for stealing nearly $85,000 in New York state pension payments meant for her deceased father, State … retirement system,” DiNapoli said. “Thanks to the work of my office and Albany County District Attorney David Soares, … a signatory or account holder, received $67,423 through an online payment platform from the account. Additionally, …
https://www.osc.ny.gov/press/releases/2024/06/dinapoli-queens-woman-pleads-guilty-stealing-85000-nys-pension-payments-meant-her-deceased-father