From the Office of the New York State Comptroller
Thomas P. DiNapoli
March 16, 2017, Contact: Press Office (518) 474-4015
State Comptroller DiNapoli Releases State Audits and Examinations
New York State Comptroller Thomas P. DiNapoli announced today the following audits and examinations have been issued:
Office of Temporary and Disability Assistance (OTDA): Wage Subsidy and Transitional Employment Programs (Follow-Up) (2017-F-1)
An initial audit released in March 2016 found OTDA needed to develop a system to more easily and readily store, access, and analyze complete wage, subsidy and transitional information and require contractors to maintain supporting documentation, including payroll records, time sheets, paystubs, or canceled checks, to support program milestones, goal achievement, and wage subsidies. In a follow-up, auditors found OTDA officials have made significant progress in addressing the problems identified in the initial audit.
New York State Health Insurance Program (NYSHIP): United HealthCare: Overpayments for Services Provided by Long Island Bone and Joint LLP (2016-S-8)
LI Bone and Joint routinely waived Empire Plan members' required out-of-pocket cost-sharing obligations for services provided. The Empire Plan is the primary health benefits plan for NYSHIP. The New York State Department of Civil Service contracts with United HealthCare (United) to process and pay medical claims from health care providers for services provided to Empire Plan members. Auditors found United made $507,530 in overpayments on claims submitted by LI Bone and Joint. Further, by not collecting members' out-of-pocket costs, LI Bone and Joint negated the incentive for members to use participating providers. This likely resulted in additional increased costs to the Empire Plan, and consequently, taxpayers.
State University of New York: Upstate Medical University's Billing Practices (2016-S-50)
For the two fiscal years under review, Upstate wrote off nearly $17.4 million in insurance denials. Records tested showed the causes for the write offs were isolated in nature and largely attributable to human error or changes to the billing system, and thus not reflective of a systematic weakness in Upstate's billing process. In addition, the amounts written off represents about 1 percent of the net patient revenue, an amount well within the industry standard of 1 to 2 percent set by the Healthcare Financial Management Association.
For access to state and local government spending, public authority financial data and information on 130,000 state contracts, visit Open Book New York. The easy-to-use website was created to promote transparency in government and provide taxpayers with better access to financial data.