health - new york state comptroller auditing paralegal legal other consulting amount payable under...

Health3450000Part 2 of 2

From: 05/13/2014 15:46 #237 P.027/033

FORM B ose Use Only:

Reporting Code:

Category Code:

State Consultant ServicesContractor's Annual Employment Report

Report Period: April 1,2013 to March 31, 2014

Contract Term:

ContractingState AgencyName:

Contract Number: CJA,'l r.$'"2c( g i.{.62{

Y I { /26 [3 ~ S /6(1)-6/::;AgencyCode:

Contractor Name: New York State Technology Enterprise Corporation (NYSTEC)

ContractorAddress: 500 Avery Lane, Suite A Rome, NY 13441

Descriptionof Services Being Provided: Technology Consulting

Scope of Contract (Choose one that best fits):Analysis Evaluation Research TrainingData Processing Computer Programming Other IT consultingEngineering Architect Services Surveying Environmental ServicesHealth Services Mental Health ServicesAccounting Auditing Paralegal Legal Other Consulting

Amount Payable Under theEmployment Category Number of Employees Number of Hours Worked Contract

11-3021.00 Computer andInformation Systems 5 dO~4 y()~LjJS:SManagers

Total this page c:., 00S4 TjoSLi5S,5Grand Total ~ 0101;.:, L)., s'-I] <;;S

Name of personwho prepared this repo Jana S. Behe

Preparer'sSignature:. -::-..,....., ....,q.-"-.J..a~=~.,____---------Title: General Counsel & CCO 518.431.7031Date Prepared: 5/9/2014Use additional pages if necessary) Page 1 of 1

From: 05/13/2014 15:46 #237 P.026/033

FORM B OSC Use Only:

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Report Period: April 1,2013 to March 31, 2014

Contract Term: i 111/2o{ 3 -- 9/30/~/L/( ZUOO

ContractingStateAgencyName:D6 .ft--Contract Number: AgencyCode:

ContractorName: NewYork State Technology Enterprise Corporation (NYSTEC)

ContractorAddress: 500Avery Lane, Suite A Rome, NY 13441

Descriptionof ServicesBeingProvided: Technology Consulting

Scope of Contract (Choose one that best fits):Analysis Evaluation Research TrainingData Processing Computer Programming Other IT consultingEngineering Architect Services Surveying Environmental Servlces 'Health Services Mental Health ServicesAccounting Auditing Paralegal Legal Other Consulting

Amount Payable Under theEmployment Category Number of Employees Number of Hours Worked Contract

11-3021.00 Computer a~dInformation Systems

3 crisiS III(2.7, CiSManagers

Total this page .~ '-1'i1 )" n i2 1,l.j)Grand Total ~\ <t'~ C; rl.f2'}-(.{\

Use additional pages if necessary) Page 1 of 1

Nameof personwho prepared this report: Jana S. Behe

Pre parer's Siqnature: ~Title: General Counsel & C Phone#:Date Prepared: 5/9/2014

518.431.7031

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Report Period: April 1, 2013 to March 31, 2014

Contracting State Agency Name: Department of HealthContract Number: CMS1050Contract Term: 04/01/13 to 12/31/13

Agency COd3'f )" D ~ 0 0

Contractor Name: Unisys CorporationContractor Address: 1DB Madison Ave Ext. Albany, NY 12203Description of Services Being Provided: Information Technology Consulting Services

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation0 Research0 Training0Data Processing0 Computer Programming0 Other IT consulting ~Engineering0 Architect Services0 Surveying0 Environmental Services0Health Services0 Mental Health Services0Accounting0 Auditing0 Paralegal0 Legal0 Other Consulting0

, O'Net Employment Category Number of Employees Number of Hours Worked Amount Payable Under(see O·Net on-line at online.onetcenter.org) the Contract

Computer Systems Analysts 3 2,857 $463,633.96Computer and Information System 2 1762 $400,291.16ManagersComputer Software Engineer, 9 9011 $1,188,264.63ApplicationSoftware Quality Assurance 1 1414 $145,316.78Engineer and Tester

Total this page 15 15044 $2,197,506.53Grand Total 16

Name of person who prepared . report: Thomas P. MannixPreparer's Signature: •......•I L.-" ~ ~ ~~

Title: Contracts Manager, Unisys Corporation Phone #: 908-445-7560Date Pre ared: 5/9/2014UUse additional pages if necessary) Page 1 of 1

AC3272-S (Effective 4/12)

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New York State Consultant ServicesContractor's Planned Employment

Report Period: April 1, 2013 to March 3 J , 2014

I

Contracting State Agency Name: D-eD-I-. Df-' fI--eaJfhContract Number: c.-rn-rt.f41 8 Agency Business Unit: .

Contract Term: 113 1/ ~ to 1 ru 1"- Agency Department ID: 3YSObOOContractor Name: Cmf' COY"lS\.,Ll ~ Se.v\l\<=-es Q.o\ L~IN.i. I;;z.\ roContractor Address: 'loD \VD,-\ S~' .Description of Services Being Provided: ..•.

Lons,u...l ~ Sex-\flc?3 ,

Scope of Contract (Choose one that best fits):

o Analysis DEvaluation o Research o Tra~ing

o Data Processing o Computer Programming [jJ6ther IT consulting

o Engineering o Architect Services o Surveying o Environmental Services

o Health Services o Mental Health Services

o Accounting o Auditing o Paralegal o Legal o Other Consulting

Employment Category Number of Number of hours to Amount PayableEmployees be worked Under the Contract

-x=.~ CD0Suti-{nQ 49{) 920~ •

,

Total this page 0 0 $ 0.00

Grand Total 49(), q)().I

Page 1 of ---L

Name of person who prepared this report: be:nCl j cJSev-rYYJJ)

Title: A\R. d.e.p1-n,Preparer's Signature:~

Date Prepared: 5 I{ Yt I L\(Use additional pages, if necessary)

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Contracting State Agency Name: NYS De~artment of Health Agency Code:Contract Number: PH65769 :3 45~-O(j{)Contract Term: 1-6-2014 to 9-30-2015 3-3-2014 to 3-3-2016Contractor Name: Computer Technology Services, Inc.Contractor Address: 200 Great Oaks Blvd. Suite 211 Albany, New York 12203Description of Services Being Provided:IT staff augmentation under the HBITS contract

Scope of Contract (Choose one that best fits):Analysis IXI Evaluation 0 Research 0 Training 0Data Processing 0 Computer Programming IXI Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0

Employment Category Number of Employees Number of Hours Worked Amount Payable Underthe Contract

Business Analysis 1 421 31,785.50Computer Programming 1 160 11,561.60

Total this pageGrand Total 2 581 43,347.10

(518) 869-3591 ext. 203

Name of person who prepared this report: ;-D;;;....;;.;.a~rc;.L.....;yB;;..;a;..;;tz;;;.o.;;..l...;;.;.d ---1

~~Preparer's Signature:Title: Human Resources ManagerDate Prepared: 05/06/2014

Phone #:


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Contracting State Agency Name: NYS Department of HealthAgency Code: (DOH01 )-3450000Contract Number: PH65770Contract Term: 11/25/2013 to 611412014Contractor Name: Experis US, Inc.Contractor Address: 125 Wolf Road, Suite 508, Albany NY 12205Description of Services Being Provided: IT Consulting Services

Scope of Contract (Choose one that best fits):Analysis0 Evaluation0 Research0 Training0Data Processing0 Computer Programming0 Other IT consulting XEngineering0 Architect Services0 Surveying0 Environmental Services0Health Services0 Mental Health Services0Accounting0 Auditing0 Paralegal0 Legal0 Other Consulting0


15.1142.00 1 640.00 $46,720.00

Total this page 1 640.00 $46,720.00Grand Total 1 640.00 $46,720.00

()

Name of person who prepared this report: AaronTell~it{ DY1 =-'IlL 'j 1ecJPreparer's Signature: C 'ANL ~ pTitle: Invoice Professional Phone #: 480~777-6663 ......,

Date Prepared: 05/09/2014


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Contracting State Agency Name: Department of Health Agency Code: 12000 .-Contract Number: PH65780 3~S 0 6 6 (jContract Term: 11/1/2012 to 10/31/2017Contractor Name: MVP Consulting Plus, Inc.Contractor Address: 435 New Karner Road Albany, NY 12205Description of Services Being Provided: Hourly Based IT Services

Scope of Contract (Choose one that best fits):Analysis Evaluation D Research D Training DData Processing D Computer Programming Other IT consulting XEngineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D Paralegal D Legal D Other Consulting D

Employment Category Number of Employees Number of Hours WorkedAmount Payable Under

the Contract

15-1131.00 1 1,738 $100,317.3615-1199.02 1 1,232 $118,653.9215-1131.00 1 632 $42,268.1615-1151.00 1 464 $15,516.1615-1199.01 1 578 $30,154.2615-1131.00 1 605 $33,988.90

Total this page 6 5,249 $340,898.76Grand Total 6 5,249 $340,898.76

Name of person who prepared-this report: Ilakumari N. PatelPreparer's Signature: __ INfO-.•......-'-'-"<(;;tU;:;..="'-- _Title: CEO Phone #: 518-218-1700Date Pre ared: 4/24/2014Use additional pages if necessary) Page 1 of 1


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Contracting State Agency Name: NYS OGS HBITSIDOH DON Agency Code: 3450270Contract Number: PR65772Contract Term: 11/01/2012 to 10/31/2017Contractor Name: GENESYS Consulting Services, Inc.Contractor Address: 2 Computer Drive West, Suite 101, Albany, NY 12205Description of Services Being Provided: Hourly Based IT Services

Scope of Contract (Choose one that best fits):Analysis D Evaluation D Research 0 Training 0Data Processing D Computer Programming ~ Other IT consulting DEngineering 0 Arch itect Services 0 Surveying 0 Environmental Services 0Health Services D Mental Health Services 0Accounting 0 Auditing D Paralegal 0 Legal 0 Other Consulting 0


Proqrammer Expert Normal 1 2,046.25 $171,066.50

Total this paqe 1 2,046.25 $171,066.50Grand Total 1 2,046.25 $171,066.50

Name of person who prepared this report: Crista MaielloPreparer's Signature: fA.A~J11t?uul!,()Title: Business Office Manager Phone #: 518-459-9500Date Pre ared: 5/2/2014"- - -Idditional pages if necessary) Page 1 of 1

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Contracting State Agency Name: NYS OGS HBITS/DOHContract Number: PR65772Contract Term: 11/01/2012 to 10/31/2017

Agency Code: 12000

~\frD 00 ()

Contractor Name: GENESYS Consulting Services, Inc.Contractor Address: 2 Computer Drive West, Suite 101, Albany, NY 12205Description of Services Being Provided: Hourly Based IT Services

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation 0 Research D Training DData Processing 0 Computer Programming ~ Other IT consulting 0Engineering 0 Architect Services D Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal D Legal 0 Other Consulting 0


Business Analyst Expert High 1 340.00 $25,493.20Technical Architect Senior High 1 1,326.00 $114,911.16

Total this page 2 1,666 $140,404.36Grand Total 2 1,666 $140,404.36

Name of person who prepared this report: Crista MaielloPreparer's Signature: eA M4< J!l1WLLaTitle: Business Office Manager I' Phone #: 518-459-9500Date Pre ared: 5/2/2014Use additional pages if necessary) Page 1 of 1

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p.16



Contracting State Agency Name: Department of HealthAgency Code: unknownContract Number: PR65777/PH65777Contract Term: 11/01 12012 to 10f 30 12017Contractor Name: Logic House Ltd.Contractor Address: 49950 Jefferson Street, Suite 130-391, Indio CA 92201Description of Services Being Provided: Various Hourly Based IT ServicesAgency Business Unit: unknown Agency Department 10: unknown

Scope of Contract fChoose one that best fits):Analysis 0 Evaluation 0 Research 0 Training-OData Processing 0 Computer Programming X Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal0 Other Consulting 0


Computer Programmer 2 1,001.50 s 48,363.92

Total thispa~e 2 1,001.50 $ 48,363.92Grand Total 2 1,001.50 $ 48,363.92

/ fName of person who pr~ ;?'L Keith A. HousePreparer's Signature: Y1 ~ rTitle: Vice President 1/ -y Phone#: 310871-2790Date Prepared: 5 I 12 12014Use additionar pages if necessary) Page 1 of 1


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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S023879Contract Term: 1/1/2010 to 12/31/2014Contractor Name: Charles H. Debrovner, MDContractor Address: 165 West End Avenue, #290, New York, NY 10023Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation IZI Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0

Employment Category Number of Employees Number of Hours Amount Payable Under theWorked Contract

Physicians and Surgeons, All Others 1 735.00 $44,100.00


Phone #: t 71.. ~) 7 I.) ]) J


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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S024667Contract Term: 4/1/2009 to 3/31/2014Contractor Name: Angel A. Gutierrez, MDContractor Address: 33 Gates Circle, #9E Buffalo, NY 14209Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis0 Evaluation IZI Research0 Training0Data Processing0 Computer Programming0 Other IT consulting0Engineering0 Architect Services0 Surveying0 Environmental Services0Health Services0 Mental Health Services0Accounting0 Auditing0 Paralegal0 Legal0 Other Consulting0


Internists, General 1 945.00 $56,700.00+ travel $353.64

Total this page 1 945.00 $57,053.64Grand Total 1\ 945.00 $57,053.64

IName of person who prepared this re r\1bm ge ,p ~,MDPreparer's Signature: ,

Title: Medicalcoordina,~ ,"\"\;;!

Phone #: 1\'h ' X ~ 6 vfjO ~0Date Prep_ared: /7 V

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Contracting State Agency Name: Department of HealthContract Number: S025854Contract Term: 1/1/2010 to 12131/2014Contractor Name: Robert Rosenblatt, MDContractor Address: 49 Carstead Drive, Slingerlands, NY 12159Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Agency Code:?;Li SOOOO

Scope of Contract (Choose one that best fits):Analysis D Evaluation C8J Research D Training DData Processing D Computer Programming D Other IT consulting DEngineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D Paralegal D Legal D Other Consulting D

Employment Category Number of EmployeesNumber of Hours Amount Payable Under the

Worked Contract



Name of per~on who preparefl}t.~ ~~: ob~~ f3o..,.:.n~t,!WPreparer's Signature: /_ ~ I--'----'=---''VC':::....-_V'--'-/t.~ 2-1- ~:-- __Title: Medical Coordinator Phone #: .jMJ ,.,If ..>'18 '3QI 4S"~-Date Pre ared: '1 'Z.-8 I



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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S025855Contract Term: 1/1/2010 to 12131/2014Contractor Name: Marvin Lipkowitz, MDContractor Address: 11 Dorset Road, Great Neck, NY 11020Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation [8J Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0


Worked Contract



Name of person who prePreparer's Signature:-4'-'4L4~cz...L,t14~~UlIo!lo!\..L.!...l. --:-__ -;:-f -T~

Title: Medical Coordin tor Phone #: '],. (2--- r;in Lipkowitz, MD

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Contracting State Agency Name: Department of HealthContract Number: S026188Contract Term: 4/1/2010 to 12131/14Contractor Name: J. Thalia Cunningham, MDContractor Address: 18 Boylston Drive, Delmar, NY 12054Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Agency Code: 120003l.\ "S 0000

Phone #:

Scope of Contract (Choose one that best fits):Analysis D Evaluation ~ Research D Training DData Processing D Computer ProgrammingD Other IT consulting DEngineering D Architect ServicesD Surveying D Environmental Services DHealth Services D Mental Health ServicesDAccounting D Auditing D ParalegalD Legal D Other Consulting D


the Contract

Physicians and Surgeons, All Other 1 994.00 $59.640.00+ travel $340.93


Name of person who prepPreparer's Signature:_.::.....",~,t....l,,<~-ES_=::...-_-f:,,-""::::...._=:::..- _

Title: Medical CoordinatorDate Pre ared:

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Report Period: April 1, 2013 to March 31,2014

Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S026189Contract Term: 4/1/2010 to 12/31/2014Contractor Name: Mieczyslaw Finster, MDContractor Address: 136 East 76th Street, New York, NY 10021Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation C8J Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting 0 Auditing D Paralegal 0 LegalD Other Consulting D


Anesthesioloqists 1 1,110.00 $66,000.00

Total this paqe 1 1,110.00 $66,000.00Grand Total 1 1,110.00 $66,000.00



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Contracting State Agency Name: Department of HealthContract Number: S026190Contract Term: 4/1/2010 to 12131/2014

Agency Code:

"3L\SC>OOOContractor Name: Michael L. Gelfand, MDContractor Address: 82 Oakmont Street, Road, Niskayuna, NY 12309Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation ~ Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0


Surgeons 1 517.50 $31,050.00+ travel $172.82


Name of person who prepared this report: Michael L. Gelfand, MDPreparer's Signature: fV'\../j; '-~ 7/,,4.A. ~-\...2Title: Medical Coordinator I p;Z #:Date Pre ared: S" s- \ "( - L{ 02-' ?.5 L- )?

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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S026191Contract Term: 4/1/2010 to 12131/2014Contractor Name: Burt R. Meyers, MD PCContractor Address: 159 New Broadway, Hastings on Hudson, NY 10706Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation [gI Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0


Internists, General 1 930.00 $55,800.00


Name of per~on who P~~it$ Burt R. Meyers, MDPreparer's Signature: ..a-t...-:z-.

Title: Owner Phone #:Date Pre ared:

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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S026193Contract Term: 4/1/2010 to 12131/2014Contractor Name: Alvin Rudorfer, DOContractor Address: 6 Rutland Road, Great Neck, NY 11020Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis0 Evaluation [8] Research0 Training0Data Processing0 Computer Programming0 Other IT consulting0Engineering0 Architect Services0 Surveying0 Environmental Services0Health Services0 Mental Health Services0Accounting0 Auditing 0 Paralegal0 Legal0 Other Consulting0


Physicians and Surgeons, AllOthers 1 1,459.00 $87,540.00

Total this page 1 1,459.00 $87,540.00Grand Total 1 1,459.00 $87,540.00

/7 ~ /II

Name of person who prepared ~0l'%~rer, DOPreparer's Signature: '~w,Title: Medicalcoordinat~!~ p

t/I/ Phone #:Date Prepared: t.j 171Use additional pages if necessary) Page 1 of 1

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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S026954Contract Term: 4/1/2011 to 12/31/2015Contractor Name: Tano S. Carbonaro, MDContractor Address: 1560 Forest Hill Road, Staten Island, NY 10314Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis0 Evaluation ~ Research0 Training0Data Processing0 Computer Programming0 Other IT consulting0Engineering0 Architect Services0 Surveying0 Environmental Services0Health Services0 Mental Health Services0Accounting0 Auditing 0 Paralegal0 Legal0 Other Consulting0


Surgeons 1 945.00 $56.700.00

Total this page 1 945.00 $56.700.00Grand Total 1 945.00 $56.700.00

/1 /11/ If

Name of person who pre~ f~~rbo~lro;~Preparer's Signature: ~ ~)~ A

Title: Medical Coordinator /v Phone #: . 1?~vl/-VIfJDate Prepared:Use additional pages if necessary) Page 1 of 1

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Contracting State Agency Name: Department of HealthContract Number: S026956Contract Term: 4/1/2011 to 12/31/2015

Agency Code:34S00QO

Contractor Name: Carl A. Paulsen, MDContractor Address: 14 Hummingbird Court, Schenectady, NY 12309Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis D Evaluation ~ Research D Training DData Processing D Computer Programming D Other IT consulting DEngineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D Paralegal D LegalD Other Consulting D


Surgeons 1 888.50 $53,310.00


r AName of person who preJf1Jlf~eport~arl A. Paulsen, MDPreparer's Signature: . II. IJ.~

Title: Medical coor~tator-H- 'Sl'ij' - ':3i"'l. ~ '5"'b' ~

Phone #: \.tl 5""l~ - 1.\-0'), - D8"7!)'Date Prepared: 01-\ 'l.q-\fl..Ol\f


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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S026957Contract Term: 4/1/2011 to 12131/2015Contractor Name: Lawrence J. Severino, MDContractor Address: 200 Saxon Woods Road, White Plains, NY 10605Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation [8J Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0


Obstetricians and Gynecologists 1 697.50 $41,850.00

"'-"~'~"'~--'-----

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••••••• y •• ~ ••••••• - ••• - • ......... __ ...-..-._._ ...- ....... _ ............ _._----. - --.

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/J /)Name of person who prepared thif~rt: Lawrenc(j~veri 0, MD 6"U1I1A'~ Jh{'fPreparer's Signature: r/7~,,",,~ {JojPAI ~

<./ fi~ ~'I'{ - (; 5''f' ~ tt 2...Title: Medical Coordinator Phone #:I Date Pre~ared: fM r :kNUse additional pages if necessary) Page 1 of 1


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Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S026958Contract Term: 4/1/2011 to 12/31/2015Contractor Name: Hedva Shamir, MDContractor Address: 44 West ea= Street, Apt 20E, New York, NY 10023Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis D Evaluation ~ Research D Training DData Processing D Computer Programming D Other IT consulting DEngineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D. Paralegal D Legal D Other Consulting D




Name of per~on who pretfed trport: Hed~~Preparer's Signature: q: 11 11 <> /\ ~

o 0 = Ph~ne#: (Q l( (6 d C(~ 31V-------

Title: Medical CoordinatorDate Pre ared:Use additional pages if necessary) Page 1 of 1

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Report Pertod: April 1. 2013 to March 31. 2014

Contracting State Agency Name: Department of HealthContract Number: 5027586Contract Term: 1/1/2012 to 12131/2016Contractor Name: Ann cea, MDContractor Address: 8 Shore Road, Stony Brook, NY 11790Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewinginterviews with physicians either under investigation or on probation.

Agency Code: 120003<15 tj(JO

Scope of Contract (Choose one that best fits):Analysis0 Evaluation181 Research0 Training0Data Processing0 Computer Programming0 Other IT consulting0Engineering0 Architect Services0 SurveyingD EnvironmentalServicesDHealth Services0 Mental HealthServicesDAccounting0 Auditing0 Paralegal0 LegalD Other Consulting0

Employment Category Number of Employees Number of Hours Worked Amount Payable Underthe Contrad

Physiciansand Surgeons,AllOthers 1 318.00 $19080.00

Total this page a 318.00 $19080.00GrandTotal 318.00 $19,080.00

Name of person who preparjd thisj'eport: Ann Cea, MDp~e~arer's Signature: CAfc== ~ C:..?4--(t~ _Title. N\;.ol, c ;.i I C01) /~ I tJ v1cTo '7 No.\) Phone #: q(L( - gZJL{ - :z.~d:>3Date Pre ared: o I

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State Consultant ·ServicesContractor's Annual Employment Report


Contracting State Agency Name: Department of Health Agency Code: 12000Contract Number: S027587Contract Term: 1/1/2012 to 12/31/2016Contractor Name: Roy Nelson, MDContractor Address: 56 Drake Lane, Manhasset, NY 11030Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewinginterviews with physicians either under investigation or on probation.

Scope of Contract (Choose one that best fits):Analysis D Evaluation [8J Research D Training DData Processing D Computer Programming D Other IT consulting DEngineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D Paralegal D Legal D Other Consulting D


the Contract


Total this paqe 0 1,215.00 $72,900.00Grand Total 1,215.00 $72,900.00

Name of person who prep;a this, rrRort: Roy Nelson, MDPreparer's Signature: _ N~Title: Phone #:Date Pre ared: '1/py. It.(Use additional pages if necessary) Page of

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Contracting State Agency Name: Department of HealthContract Number: S028775Contract Term: 4/1/2013 to 12131/2017Contractor Name: Elisabeth Zausmer, MDContractor Address: 33 Gates Circle, #9E Buffalo, NY 14209Description of Services Being Provided: Medical Coordinators provide professional medicalconsultation for the Office of Professional Medical Conduct. Duties include reviewingprofessional medical conduct cases and patient records and conducting interviews withphysicians either under investigation or on probation.

Agency Code: 12000

Scope of Contract (Choose one that best fits):Analysis0 Evaluation ~ Research0 Training0Data Processing0 Computer Programming0 Other IT consulting0Engineering0 Architect Services0 Surveying0 Environmental Services0Health Services0 Mental Health Services0Accounting0 Auditing0 Paralegal0 Legal0 Other Consulting0


Worked Contract

Physicians and Surgeons, All Others 1 1,213.75 $72,825.00


Name of person who pre@ his port: Elisabeth Zausmer, MDPreparer's Signature :_-L"'/2::/;..?'.::::::::.:=._:::p:,.~a;&:l~/ZL!.:.~L.:::::.::':":=========--.= ..."",..._,.--. _Title: Medical Coordinato Phone #:7/t:-- 1/7,)..-'7 ? f/ ~

Date Pre ared:Useadditional pages if necessary) Page 1 of

OSC Use Only:FORMB

Reporting Code:Category Code:

State Consultant ServicesContractor's Annual Employment Report, .

Report Period: AprIl1~·.2013 to March 31, 2014

Contracting State Agency Name: NYS Department of HealthContract Number: T028676Contract Term: 04/01/2013 to 06/30/2013

Agency Code:. .345DbOD

Contractor Name: PGP Associates, LLCContractor Address: 3 Park Lane W, # 11, Menands, ~Y 12204Description of Services Being Provided: Consulting Services

Scope of Contract (Choose one that best fits):Analysis 0 Evaluation 0 Research 0 Training 0Data Processing 0 Computer Programming ~ Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0

Employment Category Number of Number of Hours Amount PayableEmployees Worked Under the Contract

1'5-1021.00 Computer Programmer 0 445 $30,260.00

Total this page 0 0 $ 0.00Grand Total 0 445 $30,260.00

Name of per~on who prepared!?,~~ Ramalinga R. PernatiPreparer's Signature: ~Title: Director -----;,,....~===!::::-J-----p-ho-n-e-#-:-5-1-8--2-0-7 --1-4-8-1--

Date Pre ared: 05/13/2014Use additional pages if necessary) Page 1 of 1'.

','

.",

FORM BOSC Use OnlyReporting Code:Category Code:

State Consultant Services

Contractor's Annual Employment ReportReport Period: April 1, 2013 to March 31, 2014

New York State Department of Health Agency Code 12000Contract Number:T028727Contract Start Date: 7/1 /2013 Contract End Date: 6/30/2016Contractor Name: Medical Answering Services, LLCContractor Address: PO Box 12000, Syracuse, NY 13218Description of Services Being Provided: Medicaid Transportation Management

Preparer's signature:Date Prepared: 5/29/14 Page 1 of 2

(use additional pages if necessary)

Scope of Contract (Chose one that best fits):Analysis Evaluation ResearchTraining Data Processing Computer ProgrammingOther IT Consulting Engineering Architect ServicesSurveying Environmental Services C r-Health Services~Mental Health Services Accounting AuditingParalegal Legal Other Consulting

Employment Category Number of Number of Amount PayableEmployees Hours to be Under the

Worked Contract11-1021.00 1 1,500 $62,00043-1011.00 8 16,400 $252,00043-4051.00 35 73,200 $796,00043-9022.00 1 2,600 $33,00043-30993.00 2 4,100 $51,00011-2031.00 1 2,000 $48,00013-1111.00 1 1,000 $10,00011-9199.02 1 500 $16,00019-3022.00 1 2000 $26,00013-1151.00 1 1,600 $31,000

Totals this page: 52 104,900 $1,325,000.00Grand Total: 0 0 $ 0.00

Name of person who prepared this report: Wayne FreemanTitle: COO Phone #: 315-701-7009

Page 1 of 3

· ,

FORM BOSC Use OnlyReporting Code:Category Code:



New York State Department of Health Agency Code 12000Contract Number:T028727Contract Start Date: 7 /1 /2013 Contract End Date: 6/30/2016Contractor Name: Medical Answering Services, LLCContractor Address: PO Box 12000, Syracuse, NY 13218Description of Services Being Provided: Medicaid Transportation Management

Scope of Contract (Chose one that best fits):Analysis Evaluation ResearchTraining Data Processing Computer ProgrammingOther IT Consulting Engineering Architect ServicesSurveying Environmental Services C Health Services~Mental Health Services Accounting AuditingParalegal Legal Other Consulting


Worked Contract15-1151.00 1 900 $25,00049-9071.00 1 500 $900013-2011.01 1 1,500 $52,00043-3051.00 1 1,000 $20,00011-3121.00 1 500 $15,00013-1071.00 1 1,000 $15,00043-9051.00 1 400 $5,000

Totals this page: 7 5,800 $ 141,000.00Grand Total: 59 110,700 $ 1,466,000.00

Name of person who prepared this report: Wayne FreemanTitle: COO A Phone #:315-701-7110

t?lAht A",L'T1lJ-"f'~Preparer's signature:· • ~or~Date Prepared: 5/29/14 Page 2 of 2


Page 2 of 3

OSC Use OnlyReporting Code:category Code:


FORM BContractor's Annual Employment Report


New York State Department of Health Agency Code 12000Contract Number: T028936Contract Start Date: 04/01/2013 Contract End Date: 12/31/2013Contractor Name: United Hospital Fund of New York, Inc.Contractor Address: 1411 Broadway, 1ih Floor, New York, NY 10018

Description of Services Being Provided: SIM Project

Scope of Contract (Chose one that best fits):Analysis >I Evaluation ResearchTraining Data Processing Computer ProgrammingOther IT Consulting Engineering Architect ServicesSurve~ing Environmental Services Health ServicesMental Health Services Accounting AuditingParalegal Legal Other Consulting


Worked ContractPolitical Scientist 19-3094.00 1 254 $ 27,143.00Executive Secretaries & Administrative 1 79 $ 2,697.00Assistants 43-6011.00

Totals this page: 2 333 $ 29,840.00Grand Total: 2 333 $29,840.00

Name of person who prepared this report: Sheila M. AbramsTitle: Senior VP for Administration and Finance Phone #: 212-494-0717

Preparer's signature: ~~ Vl1 .A~ ,svP LJ.,HFDate Prepared: 05/13/2014 Page 1 of 1


Page 1 of 2

May-15-2014 03:29pm From-IPRO ADMIN. 516 326 7791 T-676 P.012/024 F-572

FORM Bosc Use OnlyReporting Code:Category Code:



Cardiac Validation Study 2013

New York State Department of Health Agency CodeContract Number: TBAContract Start Date: 06/ 18/2012 Contract End Date: 01/31/2013Contractor Name: Island Peer Review Organization, Inc.Contractor Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002

Description of Services Being Provided:

Scope of Contract (Chose one that best fits):Analysis Evaluation ResearchTraining Data Processinq Computer ProgrammingOther IT Consultinq Engineering Architect ServicesSurveying Environmental Services Health Services XMental Health Services Accounting AuditinqParaleqal Legal Other Consulting


Worked .Contract11-9199.99ManagersAll Others 1 240 2839429-1111.00Reqlstered Nurses 5 803.5 5141043-6014.00 Secretaries 1 9.1 405

Totals this page: 7 1,052.60 80,209.00Grand Total: 7 1,052.60 80,209.00

Name of person who prepared this report:Title: Senior Director of Finance

Preparer's Signature: ~ ~ 0

Date Prepared: 5 /13/14

Daniel A. SchweitzerPhone #: 516-326-7767

A~(use additional pages if necessary)


FORM BOSc...Use OnlyReporting Code:Category Code:



HRI Cancer Screening Evaluation

New York State Department of Health Agency Code 12000Contract Number: 4483-02Contract Start Date: 6/ 30/2013 Contract End Date: 06/29/2014Contractor Name: Island Peer Review OrganizationContractor Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002


Scope of Contract (Chose one that best fits):Analysis Evaluation ResearchTraining Data Processing Computer ProqrammingOther IT Consulting Enqineerinq Architect ServicesSurveyinq Environmental Services Health Services XMental Health Services Accounting AuditingParalegal Legal Other Consulting


Worked Contract15-1051.00 Computer Systems 2 358.0 33,65029-1069-99 Physicians& 1 300.7 63,556Surgeons11-9199.99 Managers 1 331.9 3290843-9111-00 Statistical Assistants 2 146.4 1151543-9199-99 Office & Admin Supp 1 11.0 542

Totals this page: 7 1,148.0 142,171Grand Total: 7 1148.0 142,171

Name of person who prepared this report: Daniel A. SchweitzerTitle: Senior Director of Finance Phone #: 516-326-7767

Preparer's signature: CC) ~ ~ s:< ~~Date Prepared: 5/13/14 Page 1 ofpf'



FORM BOS.c...UseQnlyReportingCode;Category Code;



HRI -RYAN WHITE Part B

New York State Department of Health Agency Code 12000Contract Number: 3662-05Contract Start Date: 4/01 /2013 Contract End Date: 03/31/2014Contractor Name: Island Peer Review OrganizationContractor Address: 1979 Marcus Avenue! Lake Success, NY 11042-1002


Scope of Contract (Chose one that best fits):Analysis Evaluation ResearchTraining Data Processing Computer ProqrarnrmnqOther IT Consulting Engineerinq Architect ServicesSurvevlnq Environmental Services Health Services XMental Health Services Accounting AuditingParalegal Legal Other Consulting


Worked Contract29-1111.00 Reqistered Nurses 2 1,526.4 126,37315-1051.00 Computer Systems 1 907.0 42/69843-9111-00 Statistical Assistants 1 626.2 33/85743-9199.99 Office & Admin 3 1201.7 3645711-9199.99 Managers 5 1184.2 10383429-1069-99 Physicians & 1 553.0 32,879Surgeons-

Totals this page: 13 5,998.5 376,098Grand Total: 13 5,998.5 376,098

Name of person who prepared this report: Daniel A. SchweitzerTitle: Senior Director of Finance Phone #: 516-326-7767

, . ~ ..••... \PreparerS signature: v" ....Date Prepared: 5 /13/14

c:P ~~

Page 1 of 1(use additional pages if necessary)

OSC Use Only:FORM B

Reporting Code:Category Code:



Contracting State Agency Name: - P&Pr t/F f{ijt--,-,s-Contract Number: NAContract Term: 1/1/2014 to 12/31/2015Contractor Name: CASAColumbia®Contractor Address: 633 Third Ave., ts" Floor, New York, NY 10017Description of Services Being Provided: Evaluation of Health Homes Program

Agency Code:

3'-fSD(JOG

Scope of Contract (Choose one that best fits):Analysis D Evaluation IZI Research D Training DData Processing D Computer Programming D Other IT consulting DEngineering D Architect Services D Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D Paralegal D Legal D Other Consulting D

Employment Category Number of Number of Hours Amount PayableEmployees Worked Under the Contract

11-9121.01 1 38 $3,708.00

--

Total this page 1 38 $ 3,708.00Grand Total 1 38 $3,708.00

Preparer's Signature(,.·.<::.....l.4fl...Jl-<~~-.:l::::~~~Oo4=:::::;1I...:::::::....----------

Title: Associate Office ADate Pre ared: 5/1/2014


health - new york state comptroller auditing paralegal legal other consulting amount payable under...

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