Selected reports and information published by New York State's Comptroller Thomas P. DiNapoli

Selected reports and information published by New York State's Comptroller Thomas P. DiNapoli

Issued during the week ending February 3, 2013 [Click on text highlighted in bold to access the full report]


DiNapoli Finalizes Fiscal Monitoring System

State Comptroller Thomas P. DiNapoli announced Monday his office has finalized plans to implement a statewide fiscal monitoring system that would publicly identify local governments experiencing financial strain.

DiNapoli: Inappropriate Payments Cited In Kingston Audit

The city of Kingston made $23,000 in improper payments to employees for unearned leave time, according to an auditreleased Thursday by State Comptroller Thomas P. DiNapoli. As a result of the audit, former fire chief Richard Salzmann was arrested and charged by Ulster County District Attorney D. Holley Carnright with offering a false instrument for filing in the second degree, a class A misdemeanor.

DiNapoli: Empire BlueCross BlueShield Paying Hospitals Windfalls For Special Medical Items

New York State health insurance provider Empire BlueCross BlueShield has routinely allowed hospitals to charge excessive amounts for special medical items such as implants, drugs and blood, because they did not sign agreements to limit reimbursement for those items, according to an auditof the New York State Health Insurance Program released Friday by State Comptroller Thomas P. DiNapoli.

DiNapoli: Utica Facing Continued Fiscal Challenges

The city of Utica continues to struggle with recurring budget gaps and has nearly depleted its fund balances, according to a fiscal report issued Tuesday by State Comptroller Thomas P. DiNapoli. The report is the latest in a series of fiscal profiles on cities across the state.

Comptroller DiNapoli Releases Municipal Audits

New York State Comptroller Thomas P. DiNapoli Thursday announced his office completed audits of:

the Big Flats Fire District No. 2;

the Golden Glow Volunteer Fire Company, Inc.;

the Lincoln Fire District; and,

the Village of Richmondville.

Comptroller DiNapoli Releases School Audits

New York State Comptroller Thomas P. DiNapoli Thursday announced his office completed audits of:

the Hadley–Luzerne Central School District; and,

the Hyde Park Central School District

State Comptroller's auditors alledge that NYSHIP provider Empire Bluecross Blueshield paid excessive amounts for special medical items

State Comptroller's auditors alledge that NYSHIP provider Empire Bluecross Blueshield paid excessive amounts for special medical items

Source: Office of the State Comptroller

New York State Health Insurance Program (NYSHIP) provider Empire BlueCross BlueShield [Empire] has routinely allowed hospitals to charge excessive amounts for special medical items such as implants, drugs and blood because they did not sign agreements to limit reimbursement for those items according to an audit of the NYSHIP released on February 1, 2013 by New York State Comptroller Thomas P. DiNapoli.  

The Comptroller's Office said:
 
"DiNapoli’s auditors reviewed claims for a series of special items, finding Empire paid hospitals on average 344 percent more than the costs of the items in question. While the details of the special items cannot be disclosed due to proprietary concerns, examples of Empire’s excessive payments include:

Claim Example	Amount Empire Paid Hospital for Special Items	Hospitals’ Purchase / Acquisition Cost	Excess to Hospital
A	$82,407	$18,000	$64,407	358%
B	$94,656	$25,000	$69,656	279%
C	$102,877	$24,780	$78,097	315%
D	$80,307	$13,399	$66,908	499%
Totals	$360,247	$81,179	$279,068	344%

"DiNapoli’s auditors were unable to obtain supporting documentation from 13 hospitals for 44 selected claims for special items because Empire cannot compel the hospitals to submit that information. If Empire paid these hospitals 344 percent more than the costs of the items, the hospitals could have generated profits of nearly $1.6 million on these claims, auditors estimated.

"NYSHIP provides health insurance coverage to active and retired state, participating local government and school district employees and their dependents.

"The Department of Civil Service contracts with Empire Blue Cross and Blue Shield (Empire) to provide hospitalization coverage under the Empire Plan, the largest insurance option provided by NYSHIP. Empire processes Plan claims for hospital services and medical items in accordance with agreements it negotiates with participating hospitals.

"Empire’s hospital agreements provide for additional payments for certain special items. Agreements with many member hospitals often limit payments for special items, but others do not. For the period January 1, 2011 through March 31, 2011, Empire paid 246,870 claims totaling over $529 million for services provided to plan members. This included payments totaling $24 million for 12,990 claims for special items submitted by hospitals whose agreements did not limit Empire’s reimbursements for such items.

"DiNapoli’s auditors recommended Empire:

·        Ensure that future agreements with hospitals contain language that specifies the basis of reimbursement for the purchase and acquisition of special items; and require hospitals to provide appropriate support documentation (including invoices for special items) upon request; and

·        Develop and implement internal controls to ensure that payments for special items are made in accordance with hospital agreements.

"For a copy of the roll-up report documenting the findings on 15 hospitals visit: http://osc.state.ny.us/audits/allaudits/093013/11s17.pdf

"The audits of 11 other individual hospitals with special item payment agreements can be found under the NYSHIP section at: http://www.osc.state.ny.us/audits/index.htm "

Employee privacy and Internet Social Media

Employee privacy and Internet Social Media

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120AB1844

California’s Governor Edmund G. Brown has signed into law a bill that prohibits an employer from requiring or requesting an employee or applicant for employment to disclose a username or password for the purpose of accessing personal social media, to access personal social media in the presence of the employer, or to divulge any personal social media.

The law also prohibits an employer from discharging, disciplining, threatening to discharge or discipline, or otherwise retaliating against an employee or applicant for not complying with a request or demand by the employer that violates these provisions.

The new law provides as follows:

California Labor Code

CHAPTER  2.5. Employer Use of Social Media

§980.

 (a) As used in this chapter, “social media” means an electronic service or account, or electronic content, including, but not limited to, videos, still photographs, blogs, video blogs, podcasts, instant and text messages, email, online services or accounts, or Internet Web site profiles or locations.

(b) An employer shall not require or request an employee or applicant for employment to do any of the following:

(1) Disclose a username or password for the purpose of accessing personal social media.

(2) Access personal social media in the presence of the employer.

(3) Divulge any personal social media, except as provided in subdivision (c).

(c) Nothing in this section shall affect an employer’s existing rights and obligations to request an employee to divulge personal social media reasonably believed to be relevant to an investigation of allegations of employee misconduct or employee violation of applicable laws and regulations, provided that the social media is used solely for purposes of that investigation or a related proceeding.

(d) Nothing in this section precludes an employer from requiring or requesting an employee to disclose a username, password, or other method for the purpose of accessing an employer-issued electronic device.

(e) An employer shall not discharge, discipline, threaten to discharge or discipline, or otherwise retaliate against an employee or applicant for not complying with a request or demand by the employer that violates this section. However, this section does not prohibit an employer from terminating or otherwise taking an adverse action against an employee or applicant if otherwise permitted by law.

Employee terminated following his falsely reporting he was unable to work and engaging in unauthorized outside employment

Employee terminated following his falsely reporting he was unable to work and engaging in unauthorized outside employment  

The Appellate Division sustained the termination of a deputy sheriff’s employment as a deputy sheriff, holding that substantial evidence supports the findings that the deputy sheriff:

[1] Falsely reported that he was unable to work from October through the following June;

[2] Engaged in unauthorized outside employment: and

[3] Lied under oath when he denied engaging in such outside employment at his workers' compensation hearing.

The court ruled that there was no basis to disturb the credibility determinations of the Administrative Law Judge and that the penalty of termination “does not shock our sense of fairness,” citing Cherry v Horn, 66 AD2d 556

The decision is posted on the Internet at:

http://www.courts.state.ny.us/reporter/3dseries/2013/2013_00427.htm

Challenging the denial of an appeal of an unsatisfactory performance rating

Challenging the denial of an appeal of an unsatisfactory performance rating 
102 AD3d 586

Supreme Court denied a petition seeking to annul the determination by the New York City Board of Education denying an educator’s appeal of an unsatisfactory rating (U-rating) for school year.

The Appellate Division unanimously affirmed the lower court’s ruling, explaining that the educator “failed to show that the U-rating was arbitrary and capricious, or made in bad faith.”

The court noted that detailed observations in reports prepared by the principal and two assistant principals describing the educator's poor performance in class management, engagement of students, and lesson planning provided a rational basis for the U-rating.

Further, said the Appellate Division, the record showed that after the educator received a U-rating at the end of the prior school year and was then provided with a professional development plan at the start of the succeeding school year and, throughout that year, received professional support and had a series of classroom observations by the principal and two assistant principals. Each observation, said the court, was documented by a detailed letter to the educator noting areas of improvement and making specific recommendations for addressing continuing deficiencies.

The decision is posted on the Internet at:

http://www.courts.state.ny.us/reporter/3dseries/2013/2013_00418.htm