State Comptroller DiNapoli Releases Audits

New York State Comptroller Thomas P. DiNapoli announced today the following audits have been issued.

New York City Public Schools - College Readiness (Follow-Up) (2025-F-12)

Nearly half of all students who complete high school and go to college require remedial courses, and nearly half never graduate. In general, college readiness refers to the set of skills, behaviors, and knowledge a high school student should have before enrollment in their first year of college, as well as the ability for high school students to demonstrate the knowledge and skills required to successfully complete freshman-level college coursework. A prior audit, issued in October 2022, found that, overall, New York City Public Schools (NYCPS, formerly the New York City Department of Education) should do more to prepare students to be college ready regardless of the post-secondary pathway they decide to take, and this preparation should begin much earlier in students' school years. Specifically, for a cohort of 71,210 high school students expected to graduate by August 2019, as many as 23% did not graduate on time. NYCPS officials have made significant progress in addressing the problems identified in the initial audit report, implementing all four recommendations.

Department of Health - Medicaid Program: Oversight of Managed Care Provider Networks (2023-S-20)

Managed care organizations (MCOs) are required to submit their provider network to the Department of Health (DOH) quarterly, and this information is used to generate a deficiency report identifying areas where the MCO lacks enough providers in certain counties. MCOs are given an opportunity to dispute deficiencies and provide supporting information to have the deficiency removed and the remaining deficiencies are compiled into a quarterly Statement of Agreement for each MCO. Auditors determined that, in many instances, DOH did not follow its internal review guidance, Statements of Agreement contained inaccurate deficiencies, and deficiency statuses were not always updated, so it was unclear whether DOH took the additional steps needed to complete its quarterly network adequacy review. Auditors also found that DOH does not provide MCOs with adequate guidance regarding the deficiency review process or out-of-network provider payments, which may expose the Medicaid program to increased expenses. Further, despite having access to the Statement of Agreement data, DOH officials do not use this information to identify patterns or areas for improvement or to provide any other oversight of the network adequacy process.

Transforming Into Construction & Development (2023-S-49)

The Public Authorities Law required the Metropolitan Transportation Authority (MTA) to "develop and complete a personnel and reorganization plan" by June 30, 2019. According to the Transformation plan adopted by the MTA Board on July 24, 2019, "the MTA's transformation seeks to change the fundamental ways in which the Agencies do business in order to drive improved service levels for the customers, process efficiencies and cost reductions." At the December 2019 Board Meeting, MTA Capital Construction was renamed and reorganized to Construction & Development Company (C&D). Auditors found that, although C&D provided evidence that it had been organizationally transformed, sufficient time had not passed to comprehensively assess whether the change delivered capital projects faster, better, or cheaper, as was its plan. The data that was available was at times incomplete or insufficiently supported, and a definition of what constituted cost savings was not clearly defined and included some questionable items.

Department of Health - Medicaid Program: Improper Payments for Certain Third-Party Cost-Sharing Claims (2024-S-1)

When Medicaid members have other sources of health care coverage (third-party insurers), Medicaid is considered the payer of last resort and, as such, providers are required to coordinate benefits with third-party insurers before billing Medicaid for services. After processing a claim from a provider, the third-party insurer issues a statement to the provider, explaining the reason for any adjustments made to the claim amount. Claim Adjustment Reason Codes (CARCs) and group codes (such as PR, patient responsibility, and CO, contractual obligation) on statements detail the reason an adjustment was made to a claim and assign financial responsibility for the unpaid portion of the claim balance. CARC 45 occurs when the charge exceeds the maximum allowable fee and claims with a CARC PR 45 are currently configured to pay in eMedNY (DOH's automated Medicaid claims processing and payment system), while claims with a CARC CO 45 are not. Auditors identified 69,166 claims totaling payments of almost $10.2 million billed with a PR 45. They sampled 58 of these claims billed with a PR 45 and identified billing issues on each claim that resulted in Medicaid overpayments of $1,778,546.

New York City Department of Social Services - New York City Department of Homeless Services: Oversight of Contract Expenditures of Institute for Community Living, Inc. (Follow-Up) (2025-F-16)

In March 2014, the New York City Department of Homeless Services (DHS), an administrative unit of the New York City Department of Social Services, contracted with the Institute for Community Living, Inc. (ICL), a City-based not-for-profit organization, to provide temporary housing and other services at its 200-bed Tillary Street Women's Shelter for the period from December 2013 to December 2021. A prior audit, issued in September 2022, found DHS did not complete required expenditure reviews or ensure that year-end closeouts were completed in a timely manner. Consequently, for the three fiscal years ended June 30, 2019, auditors identified $2,376,462, or 9.7% of all reported costs, did not comply with requirements. DHS officials made some progress in addressing the issues identified in the initial audit report. Of the initial report's nine audit recommendations, one was implemented, five were partially implemented, and three were not implemented.

Office of Mental Health - Oversight of Kendra's Law (Follow-Up) (2025-F-6)

In August 1999, Kendra's Law was enacted, creating a statutory framework for court-ordered Assisted Outpatient Treatment to ensure that individuals with severe mental illness and a history of hospitalizations or violence participate in community-based services appropriate to their needs. Assisted Outpatient Treatment implementation is a joint responsibility and collaboration among the Office of Mental Health (OMH), its five regional Field Offices, and local mental health authorities in 57 counties and New York City. A prior audit, issued in February 2024, found areas in need of improvement, including length of Assisted Outpatient Treatment investigations and related information-sharing, initiation of Assisted Outpatient Treatment services, the quality and completeness of information about significant events and how that information is shared, lapsing Assisted Outpatient Treatment orders, and local mental health authorities' reported reasons for Assisted Outpatient Treatment non-renewals. OMH officials made progress in addressing the problems identified in the initial audit report. Of the report's six recommendations, three have been implemented, two have been partially implemented, and one has not been implemented.