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United HealthCare – Overpayments for Services Provided by Dr. John Gomes

… operated by Dr. John Gomes, located on Franklin Avenue in Garden City, New York. With respect to the Empire Plan, … Plan members and, as such, ostensibly waived the amounts in question. Such a practice may constitute billing fraud, as … $1,144. However, Dr. Gomes accepted the $5,228 as payment in full and ostensibly waived the $1,144 due from the member. …

Overpayments of Hospitals’ Claims for Lengthy Acute Care Admissions (Follow-Up)

… in our audit report, Overpayments of Hospitals’ Claims for Lengthy Acute Care Admissions (2010-S-30). Background … have special health care needs. When billing Medicaid for inpatient services, hospitals must indicate a patient’s … occurred primarily because hospitals billed Medicaid for higher (and more costly) levels of care when, in fact, …

Annual Assessment of Market Orders for 2012, 2013, and 2014

… documentation to support expenses, such as vehicle cost allocations, contractor bidding, and sole source …

Unnecessary Managed Care Payments for Medicaid Recipients With Medicare (Follow-Up)

… managed care premiums for enrollees of the Family Health Plus program who also have Medicare. Key Finding Department …

Village Official Heading to Prison for Stealing More Than $100,000

… State Comptroller Thomas P. DiNapoli and Oswego County … the second degree (class C felony) and falsifying business records in the first degree (class E felony). Her arrest was … encourages the public to help fight fraud and abuse. New Yorkers can report allegations of fraud involving …

DiNapoli Announces State Contract and Payment Actions for August 2014

… State Comptroller Thomas P. DiNapoli announced today his office reviewed 1,804 contracts valued at $4.3 billion and … 1.2 million payments totaling $8.6 billion in August. His office also rejected 190 contracts and related transactions … $4.4 million in grants to eight municipalities including NYC ($2.7 million) for Aid to Prosecution.  Department of …

DiNapoli: Audit Cites East Clinton Fire District For Improper Gifts

… improperly paid nearly $35,000 in personal expenses for members, including rent, cable television and college … $8,500. District officials have not sought reimbursement for the gifts or loans. During the 16-month audit period, … more than 11 hours a day, seven days a week, every week, for 16 months. The Comptroller’s audit also revealed: Bank …

York College – Time and Attendance Practices for Public Safety Staff

… officer, at straight pay rather than overtime rates. Video from surveillance cameras indicated that a sergeant was … overtime for hours that he did not actually work. Per the video footage, another officer (not the sergeant) actually …

Improper Payments of Medicare Buy-in Premiums for Ineligible Recipients (Follow-Up)

… report, Improper Payments of Medicare Buy-In Premiums for Ineligible Recipients (Report 2020-S-35 ). About the … program (Buy-in Program), administered by the Centers for Medicare & Medicaid Services (CMS), Medicaid pays Medicare premiums for individuals who meet Buy-in Program eligibility …

DiNapoli: Employment Recovery for New Yorkers with Disabilities Lags Nation

… face a higher unemployment rate than the national average for those with disabilities. In 2020, unemployment rates for working-aged people with a disability soared in both New … dropped to 8.2% in 2022, but in New York it was 11.9%. “For people living with disabilities, the COVID-19 pandemic …

“Nation’s Report Card” Underscores New York’s Need for Academic Recovery

… in the past 20 years. The results underscore the need for school districts to swiftly invest significant resources in … (NYSED) administered this process and has made each district’s approved spending plan publicly available. Under … varied from a low of 20 percent in New York City and Rochester to a high of 44 percent in Yonkers. 14  Districts’ …

Albany Leadership Charter School for Girls – Cash Collections (2022M-165)

… Albany Leadership Charter School for Girls (School) Board of Trustees (Board) and officials ensured collections were … As a result, 113 collections totaling $914,291 (99 percent of total collections remitted to the business office) were … reports did not accurately report revenue, and the risk of loss, diversion or theft of School funds was increased. …

Cantalician Center for Learning – Compliance With the Reimbursable Cost Manual

… determine whether the costs reported by Cantalician Center for Learning (Cantalician) on its Consolidated Fiscal Reports … submitted by Cantalician to SED on its 2016 and 2017 CFRs for the fiscal year ended June 30, 2017. About the Program Cantalician is an SED-approved, not-for-profit special education provider located in Depew, …

55b/c Opportunities for Wartime Veterans and Individuals With Disabilities

… Office of the State Comptroller is continuously recruiting for 55b/c eligible positions. Contact  [email protected]  for more information. How to Apply No written examination is required for appointment to either program. However, candidates are …

DiNapoli Releases Fiscal Stress Scores for Villages and Some Cities

… fiscal years, including the “Big 4” cities of Buffalo, Rochester, Syracuse and Yonkers, each of which have fiscal … other challenges that might affect a local government’s or school district’s finances. This information includes population …

IX.3 Establish & Maintain Federal Grants in SFS for Non-Onboarding Agencies – IX. Federal Grants

EmblemHealth Plan, Inc.: Overpayments for Services Requiring Coordination of Benefits

… whether EmblemHealth Plan, Inc. overpaid dental claims for members covered by two subscriber plans under the New … EmblemHealth Plan, Inc. (Emblem) to process and pay claims for services on behalf of the New York State Dental Insurance … benefits (COB) is a process health insurance companies use for paying health care claims when an individual is covered …

DiNapoli Announces State Contract and Payment Actions for May 2016

… announced today his office approved 1,636 contracts valued at $1.99 billion and approved nearly 2.2 million payments … rejected 176 contracts and related transactions valued at $180 million and more than 2,000 payments valued at nearly … $800.8 million for 632,000 personal income tax refunds. $70.7 million for 36,000 corporate and other refunds. $3.6 …

University Preparatory Charter School for Young Men - Payroll (2023M-123)

… policies and documents and examined payroll-related records for 25 of the 138 individuals employed by the School … employees received pay that was not consistent with their employment agreements, authorized pay rates or Board of … Ensure employees are paid in accordance with employment agreements, approved salaries and pay rates and …