State Audits by Agency or Authority

Eye Care Provider and Family Inappropriately Enroll as Recipients and Overcharge for Vision Services (Follow-Up)
Issued: 10/12/17

Improper Medicaid Payments to Eye Care Providers
Issued: 10/06/17

Improper Payments for Recipients No Longer Enrolled in Managed Long Term Care Partial Capitation Plans (Follow-Up)
Issued: 10/06/17

Medicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits (Follow-Up)
Issued: 10/06/17

Medicaid Program – Managed Long Term Care Premium Rate Setting
Issued: 09/27/17

Questionable Payments for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician (Follow-Up)
Issued: 09/19/17

Medicaid Program – Administrative Costs Used in Premium Rate Setting of Mainstream Managed Care Organizations
Issued: 09/13/17

Medicaid Program – Medicaid Claims Processing Activity April 1, 2016 Through September 30, 2016
Issued: 07/25/17

Medicaid Program – Inappropriate Premium Payments for Recipients No Longer Enrolled in Mainstream Managed Care and Family Health Plus
Issued: 07/11/17

Medicaid Drug Rebate Program Under Managed Care (Follow-Up)
Issued: 06/30/17

Medicaid Program – Errors in Identification of 340B Providers in the Medicaid Drug Rebate Program
Issued: 06/30/17

Medicaid Program – Medicaid Payments for Pharmacy Claims: Joia Pharmacy and a Related Prescriber
Issued: 06/27/17

Medicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
Issued: 03/01/17

Multiple Same-Day Procedures on Ambulatory Patient Groups Claims (Follow-Up)
Issued: 01/12/17

Medicaid Payments Made Pursuant to Medicare Part C (Follow-Up)
Issued: 12/15/16

Improper Payments to a Physical Therapist (Follow-Up)
Issued: 12/08/16

Medicaid Overpayments for Certain Medicare Part C Claims (Follow-Up)
Issued: 12/08/16

Medicaid Program – Improper Episodic Payments to Home Health Providers
Issued: 12/08/16

Overpayments to Managed Care Organizations and Hospitals for Low Birth Weight Newborns (Follow-Up)
Issued: 12/07/16

Medicaid Program – Medicaid Claims Processing Activity October 1, 2015 Through March 31, 2016
Issued: 11/30/16

Medicaid Program – Mainstream Managed Care Organizations: Administrative Costs Used in Premium Rate Setting
Issued: 10/13/16

Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care (Follow-Up)
Issued: 09/23/16

Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits (Follow-Up)
Issued: 09/23/16

Medicaid Program – Medicaid Claims Processing Activity April 1, 2015 Through September 30, 2015
Issued: 08/09/16

Medicaid Program - Medicaid Managed Care Organization Fraud and Abuse Detection
Issued: 07/15/16

Medicaid Program – Improper Payments for Recipients No Longer Enrolled in Managed Long Term Care Partial Capitation Plans
Issued: 03/30/16

Medicaid Program – Managed Care Organizations’ Readiness for the Encounter Intake System
Issued: 03/29/16

Medicaid Program – Eye Care Provider and Family Inappropriately Enroll as Recipients and Overcharge for Vision Services
Issued: 03/21/16

Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy (Follow-Up)
Issued: 02/18/16

Medicaid Program – Optimizing Medicaid Drug Rebates
Issued: 01/07/16

Suspicious and Fraudulent Medicaid Payments to Affiliated Brooklyn Dentists (Follow-Up)
Issued: 12/30/15

Medicaid Program – Overpayments of Ambulatory Patient Group Claims (Follow-Up)
Issued: 12/28/15

Medicaid Overpayments for Inpatient Transfer Claims Among Merged or Consolidated Facilities
Issued: 12/08/15

Medicaid Program – Medicaid Claims Processing Activity October 1, 2014 Through March 31, 2015
Issued: 12/08/15

Medicaid Program – Appropriateness of Medicaid Eligibility Determined by the New York State of Health System
Issued: 10/28/15

Improper Payments to a Dentist (Follow-Up)
Issued: 09/30/15

Medicaid Program – Questionable Payments for Practitioner Services and Pharmacy Claims Pertaining to a Selected Physician
Issued: 09/18/15

Overpayments of Hospitals’ Claims for Lengthy Acute Care Admissions (Follow-Up)
Issued: 07/07/15

Medicaid Program – Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits
Issued: 06/29/15

Medicaid Program – Medicaid Claims Processing Activity April 1, 2014 Through September 30, 2014
Issued: 06/29/15

Overpayments for Services Also Covered by Medicare Part B (Follow-Up)
Issued: 06/26/15

Medicaid Program – Medicaid Claims Processing Activity October 1, 2013 Through March 31, 2014
Issued: 05/21/15

Medicaid Program – Medicaid Drug Rebate Program Under Managed Care
Issued: 02/18/15

Medicaid Program – Improper Payments for Controlled Substances That Exceed Allowed Dispensing Limits
Issued: 02/06/15

Medicaid Program – Medicaid Claims Processing Activity April 1, 2013 Through September 30, 2013
Issued: 02/05/15

Improper Managed Care Payments for Certain Medicaid Recipients (Follow-Up)
Issued: 01/20/15

Medicaid Program - Medicaid Overpayments for Certain Medicare Part C Claims
Issued: 01/16/15

Medicaid Program – Improper Fee-for-Service Payments for Pharmacy Services Covered by Managed Care
Issued: 01/05/15

Overpayments of Certain Medicare Crossover Claims (Follow-Up)
Issued: 12/22/14

Medicaid Program – Improper Payments to a Physical Therapist
Issued: 12/15/14