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Selected Payments for Special Items Made to St. Peter's Hospital from January 1, 2011 through March 31, 2011
… (Empire's) payments to St. Peter's Hospital (St. Peter's) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to Mount Sinai Hospital from January 1, 2011 through March 31, 2011
… (Empire's) payments to Mount Sinai Hospital (Mount Sinai) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-mount-sinai-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to St. Luke's Cornwall Hospital from January 1, 2011 through March 31, 2011
… payments to St. Luke's Cornwall Hospital (St. Luke's) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-lukes-cornwall-hospital-january-1-2011-throughSelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
To determine if BlueCross BlueShields Empires payments to Arden Hill Hospital Arden Hill for special items were made according to the provisions of the ag
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-arden-hill-hospital-january-1-2011-through-march-31Selected Payments for Special Items Made to Stony Brook University Hospital from January 1, 2011 through March 31, 2011
… New York's Stony Brook University Hospital (Stony Brook) for special items were made according to the provisions of … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with … portion of the Plan. Empire processes Plan claims for hospital services in accordance with agreements they …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-stony-brook-university-hospital-january-1-2011-throughEmpire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… in our initial audit report, Controls Over Payments for Special Items (Report 2016-S-57 ). About the Program The … The Empire Plan is the primary health benefits plan for NYSHIP. Empire BlueCross (Empire) administers the … portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates …
https://www.osc.ny.gov/state-agencies/audits/2020/02/25/empire-bluecross-controls-over-payments-special-items-followUnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Follow-Up)
… therapy. We issued our initial audit report on October 27, 2021. The audit objective was to determine whether United … The audit covered the period January 1, 2015 through December 31, 2019. We identified $7.3 million in actual and …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/unitedhealthcare-insurance-company-new-york-improper-payments-acupuncture-and-acupunctureRetiree Annual Statement
… printed Statements by the end of February. Email Delivery (Online Availability): We make Statements available in Retirement Online sooner than printed copies are mailed—we will notify … benefit. Alternate Payee Deductions The amount deducted to pay to your ex-spouse per the terms of your Domestic …
https://www.osc.ny.gov/retirement/retirees/retiree-annual-statementCVS Health - Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… at all) or remit all rebate revenue to Civil Service that it collected. As a result, Civil Service was due $2,052,653 …
https://www.osc.ny.gov/state-agencies/audits/2020/12/29/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followCVS Health – Temporary Holding Account Rebate Revenue (Follow-Up)
… The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Civil … to administer the Empire Plan’s prescription drug program for the period January 1, 2014 through December 31, 2018. In … required to negotiate agreements with drug manufacturers for rebates and remit the rebate revenue to Civil Service. …
https://www.osc.ny.gov/state-agencies/audits/2020/10/15/cvs-health-temporary-holding-account-rebate-revenue-followCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… The Empire Plan is the primary health benefits plan for NYSHIP, covering 1.1 million members. Civil Service … to administer the Empire Plan’s prescription drug program for the period January 1, 2014 through December 31, 2018. In … required to negotiate agreements with drug manufacturers for rebates and remit the rebate revenue to Civil Service. …
https://www.osc.ny.gov/state-agencies/audits/2021/02/08/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followUnitedHealthcare – Reasonable and Customary Reimbursement Rates for Delayed Claims
… The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Civil … from out-of-network providers. United’s reimbursement for certain out-of-network claims is 80 percent of the R&C rate for the service. R&C rates are updated every six months. From …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsEmpire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network
… claims for hospital services according to contracts it negotiates with hospitals. The hospital contracts include …
https://www.osc.ny.gov/state-agencies/audits/2019/11/29/empire-bluecross-improper-payments-special-items-billed-hospitals-within-long-island-healthUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. Civil Service … December 2021, United paid approximately $878 million for physician-administered drugs. Key Findings We identified $5,536,537 in actual and potential overpayments for the cost of physician-administered drugs during the audit …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service
To determine if CVS Health invoiced and remitted commercial rebate revenue related to Empire Plan drug utilization in accordance with its contract with the Department of Civil Service
https://www.osc.ny.gov/state-agencies/audits/2019/01/28/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-serviceUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Follow-Up)
… of implementation of the two recommendations included in our initial audit report, Out-of-Network Providers … improvements. Key Finding United officials made progress in addressing the problems we identified in the initial audit. In particular, United saved the Empire …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesNew York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… in our initial audit report, Payments by Empire BlueCross for Hospital Services for Ineligible Members (Report 2019-S-32 ). About the Program … The Empire Plan is the primary health benefits plan for NYSHIP, covering 1.1 million members. Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2021/12/27/new-york-state-health-insurance-program-payments-empire-bluecross-hospital-servicesEmpire BlueCross – Improper Payments for Intraocular Lens Claims Billed by Hospitals
… whether Empire BlueCross properly paid hospital claims for intraocular procedures. The audit covered the period … The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Empire … portion of the Empire Plan. Empire processes claims for hospital services according to contracts it negotiates …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsDiNapoli: Former Pharmacist Pleads Guilty In $232,000 Fake Prescriptions Scam
… admitted today he faked prescriptions to steal $232,000 in a fraud that was uncovered in two audits by State Comptroller Thomas P. DiNapoli’s … defendant’s scheme and now the taxpayers of New York will get their money back.” The improper payments were exposed …
https://www.osc.ny.gov/press/releases/2015/12/dinapoli-former-pharmacist-pleads-guilty-232000-fake-prescriptions-scamEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (2011-S-42). Background The New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-through