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Incorrect Payments by CVS Caremark for Medicare Rx Drug Claims That Were Improperly Paid Under the Commercial Plan (Follow-up)
… Objective To assess the extent of implementation of the three … million members. Civil Service contracts with CVS Caremark to administer the prescription drug program for the Empire … of our initial audit, issued on September 13, 2023, was to determine whether CVS Caremark paid claims under the …
https://www.osc.ny.gov/state-agencies/audits/2025/06/18/incorrect-payments-cvs-caremark-medicare-rx-drug-claims-were-improperly-paid-underAnthem Blue Cross – Effectiveness of the Recovery Process
… where Anthem initially identified that a portion of the payment had been made incorrectly. Key Recommendations Review …
https://www.osc.ny.gov/state-agencies/audits/2026/01/06/anthem-blue-cross-effectiveness-recovery-processImproper Payments Related to the Center of Excellence for Cancer Program
… in payments still require a review to determine which payment (Anthem’s or United’s) should be remitted to Civil …
https://www.osc.ny.gov/state-agencies/audits/2026/01/27/improper-payments-related-center-excellence-cancer-programUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… To determine whether UnitedHealthcare overpaid for out-of-network anesthesia services provided at Ambulatory Surgery … Program (NYSHIP), administered by the State Department of Civil Service (Civil Service), provides health insurance … The Empire Plan provides its members with four types of health insurance coverage: medical/surgical, hospital, …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Follow-Up)
… of the Plan. Empire processes and pays Plan claims for hospital services in accordance with agreements Empire negotiates with member hospitals. Payments for hospital services are generally based on standard fee …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… of the three recommendations made in our audit report, New York State Health Insurance Program: Empire BlueCross BlueShield …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… Of the initial report’s three audit recommendations, one was partially implemented, one was not implemented and one was no longer applicable. Key Recommendation Officials …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followUnited HealthCare – Empire Plan Drug Rebate Revenue
… To determine if United HealthCare (United) remitted all drug rebate revenue to the Department of Civil Service … with United to administer the Empire Plan’s prescription drug program from January 1, 2008 through December 31, 2013. … contract, United is required to negotiate agreements with drug manufacturers for rebates, discounts, and other …
https://www.osc.ny.gov/state-agencies/audits/2016/11/01/united-healthcare-empire-plan-drug-rebate-revenueAnthem Blue Cross – Coordination of Benefits With Medicare
… Objective To determine whether Anthem Blue Cross coordinated benefits to properly pay claims … 1.1 million of the members. Civil Service contracts with Anthem Blue Cross (Anthem) to administer the Hospital Program … To determine whether Anthem Blue Cross coordinated benefits to properly pay claims …
https://www.osc.ny.gov/state-agencies/audits/2024/08/19/anthem-blue-cross-coordination-benefits-medicareNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
… four recommendations included in our initial audit report, New York State Health Insurance Program – Payments by Beacon … Members (Report 2021-S-18 ). About the Program The New York State Health Insurance Program (NYSHIP), … Plan. Civil Service is responsible for maintaining the New York Benefits Eligibility and Accounting System (NYBEAS), …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andHiring Public Retirees – When Employees Retire
… are limited if they are returning to public employment in New York State. Public employment includes: State of New York …
https://www.osc.ny.gov/retirement/employers/when-employees-retire/hiring-public-retireesState Comptroller DiNapoli Releases Municipal and School Audits
… today announced the following local government and school audits were issued. City of Dunkirk – Budget Review … going forward will be severely limited. Seaford Union Free School District – Capital Assets (Nassau County) District … today announced the following local government and school audits were issued …
https://www.osc.ny.gov/press/releases/2025/11/state-comptroller-dinapoli-releases-municipal-and-school-auditsManhasset Union Free School District – IT Asset Management (S9-22-15)
manhasset, audit, schools, statewide, IT asset management
https://www.osc.ny.gov/files/local-government/audits/2023/pdf/manhasset-union-free-school-district-s9-22-15.pdfKings Park Central School District – IT Asset Management (S9-22-13)
kings park, audit, schools, statewide, IT asset management
https://www.osc.ny.gov/files/local-government/audits/2023/pdf/kings-park-central-school-district-s9-22-13.pdfFreeport Union Free School District – IT Asset Management (S9-22-10)
freeport, audit, schools, statewide, IT asset management
https://www.osc.ny.gov/files/local-government/audits/2023/pdf/freeport-union-free-school-district-s9-22-10.pdfElmsford Union Free School District – IT Asset Management (S9-22-9)
elmsford, audit, schools, statewide, IT asset management
https://www.osc.ny.gov/files/local-government/audits/2023/pdf/elmsford-union-free-school-district-s9-22-9.pdfCentral Valley Central School District – IT Asset Management (S9-22-7)
audit, schools, statewide, IT asset management, central valley
https://www.osc.ny.gov/files/local-government/audits/2023/pdf/central-valley-central-school-district-s9-22-7.pdfWest Islip Union Free School District – Financial Management (2022M-40)
Determine whether the West Islip Union Free School District’s (District) Board of Education (Board) reasonably and transparently managed fund balance and reserves.
https://www.osc.ny.gov/files/local-government/audits/2022/pdf/west-islip-2022-40.pdfWeedsport Central School District – Procurement and Claims Audit (2021M-199)
Determine whether claims had adequate supporting documentation and were properly audited before payment.
https://www.osc.ny.gov/files/local-government/audits/2022/pdf/weedsport-2021-199.pdfEast Moriches Union Free School District - Financial Condition Management (2022M-1)
Determine whether the East Moriches Union Free School District’s (District’s) Board of Education (Board) and Superintendent effectively managed the District’s financial condition.
https://www.osc.ny.gov/files/local-government/audits/2022/pdf/east-moriches-2022-01.pdf