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Selected Payments for Special Items Made to St. Mary's Hospital from January 1, 2011 through March 31, 2011
… and St. Mary’s. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011Selected Payments for Special Items Made to Albany Medical Center from January 1, 2011 through March 31, 2011
… Empire and AMC. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-albany-medical-center-january-1-2011-through-march-31Selected Payments for Special Items Made to Mary Imogene Bassett Hospital from January 1, 2011 through March 31, 2011
… Empire and Bassett. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-mary-imogene-bassett-hospital-january-1-2011-throughSelected Payments for Special Items Made to Stony Brook University Hospital from January 1, 2011 through March 31, 2011
… and Stony Brook. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-stony-brook-university-hospital-january-1-2011-throughSelected Payments for Special Items Made to Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… and Arden Hill. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
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 St. Luke's Cornwall Hospital from January 1, 2011 through March 31, 2011
… and St. Luke's. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
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 Mount Sinai Hospital from January 1, 2011 through March 31, 2011
… determine if BlueCross BlueShield's (Empire's) payments to Mount Sinai Hospital (Mount Sinai) for special items were made according to the provisions of the agreement between Empire and Mount Sinai. Background The New York State Health Insurance …
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. Peter's Hospital from January 1, 2011 through March 31, 2011
… and St. Peter's. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, participating … Related Audits/Reports of Interest New York State Health Insurance Program: Payments Made to Stony Brook University …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-peters-hospital-january-1-2011-through-march-31Empire BlueCross – Controls Over Payments for Special Items (Follow-Up)
… and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP. Empire BlueCross (Empire) administers the hospital portion of the Empire Plan. …
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)
… and acupuncture-related services such as heat and massage therapy. We issued our initial audit report on October 27, …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/unitedhealthcare-insurance-company-new-york-improper-payments-acupuncture-and-acupunctureCVS Health – Temporary Holding Account Rebate Revenue (Follow-Up)
… Purpose To determine the extent of implementation of the two recommendations included in our initial audit report, … Holding Account Rebate Revenue ( 2019-S-27 ). Background The New York State Health Insurance Program (NYSHIP), … To determine the extent of implementation of the two recommendations …
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)
… of the five recommendations included in our initial audit report, CVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Report 2016-S-41 ). About the Program The New York State … of the five recommendations included in our initial audit report CVS Health Accuracy of Drug Rebate Revenue Remitted to …
https://www.osc.ny.gov/state-agencies/audits/2020/12/29/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… of the six recommendations included in our initial audit report, CVS Health - Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Report 2018-S-50 ). About the Program The New York State … of the six recommendations included in our initial audit report CVS Health Accuracy of Drug Rebate Revenue Remitted to …
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
… Objectives To determine whether UnitedHealthcare (United) paid claims … using reasonable and customary (R&C) reimbursement rate schedules that did not correlate with the date of the service on the claims, and to calculate the corresponding financial impact. The audit …
https://www.osc.ny.gov/state-agencies/audits/2019/12/12/unitedhealthcare-reasonable-and-customary-reimbursement-rates-delayed-claimsUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to over … plan for NYSHIP, serving about 1.1 million members. Civil Service contracts with UnitedHealthcare Insurance …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsEmpire BlueCross – Improper Payments for Special Items Billed by Hospitals Within Long Island Health Network
… Objectives To determine whether Empire BlueCross paid claims for special items according to the terms of its contract with Long Island Health Network … To determine whether Empire BlueCross paid claims for special …
https://www.osc.ny.gov/state-agencies/audits/2019/11/29/empire-bluecross-improper-payments-special-items-billed-hospitals-within-long-island-healthNew York State Health Insurance Program – Payments by Empire BlueCross for Hospital Services for Ineligible Members (Follow-Up)
… Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to over …
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
… Objective To determine whether Empire BlueCross properly paid hospital … Program (NYSHIP) provides health insurance coverage to over 1.2 million active and retired State, local … Empire processes claims for hospital services according to contracts it negotiates with hospitals. The hospital …
https://www.osc.ny.gov/state-agencies/audits/2019/12/20/empire-bluecross-improper-payments-intraocular-lens-claims-billed-hospitalsUnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Follow-Up)
… of the two recommendations included in our initial audit report, Out-of-Network Providers Upcoding Selected Evaluation and Management Services (Report 2017-S-34 ). About the Program The New York State … actually provided is known as upcoding. Our initial audit report, issued on December 31, 2018, examined whether United …
https://www.osc.ny.gov/state-agencies/audits/2020/01/03/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service
… invoiced and remitted commercial rebate revenue related to Empire Plan drug utilization in accordance with its contract … and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering 1.1 million members. The Empire Plan provides its members with four types of health …
https://www.osc.ny.gov/state-agencies/audits/2019/01/28/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service