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Selected Payments for Special Items Made to St. Mary's Hospital from January 1, 2011 through March 31, 2011
… Purpose To determine if BlueCross BlueShield’s (Empire’s) payments to St. Mary’s Hospital (St. Mary’s) for … made according to the provisions of the agreement between Empire and St. Mary’s. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-st-marys-hospital-january-1-2011-through-march-31-2011Empire BlueCross BlueShield Special Items Made to Englewood Hospital and Medical Center from January 1, 2011 through March 31, 2011
… Purpose To determine if BlueCross BlueShield’s (Empire’s) payments to Englewood Hospital and Medical Center … made according to the provisions of the agreement between Empire and Englewood. Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-special-items-made-englewood-hospital-and-medical-centerEmpire BlueCross BlueShield – Selected Payments for Special Items Made to Saratoga Hospital From January 1, 2011 Through March 31, 2011
… school district employees and their dependents. The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. … in accordance with agreements they negotiate with member hospitals, including Saratoga. Empire's payments to Saratoga … costs to acquire them. Key Finding We reviewed one claim payment to Saratoga for special items and determined Empire …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-made-saratoga-hospital-januarySelected Payments for Special Items Made to Mary Imogene Bassett Hospital from January 1, 2011 through March 31, 2011
… district employees and their dependents. The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. … in accordance with agreements they negotiate with member hospitals, including Bassett. Empire’s payments to Bassett … costs to acquire them. Key Findings We reviewed one claim payment to Bassett for special items and determined Empire …
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 Albany Medical Center from January 1, 2011 through March 31, 2011
… if BlueCross BlueShield’s (Empire’s) payments to Albany Medical Center (AMC) for special items were made according to … Insurance Program: Payments Made to Stony Brook University Medical Center (2009-S-27) New York State Health Insurance … if BlueCross BlueShields Empires payments to Albany Medical Center AMC for special items were made according to …
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 St. Luke's Cornwall Hospital from January 1, 2011 through March 31, 2011
… Plan. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … $9,327 from St. Luke’s for the overpayments we identified in this audit. Develop and implement the controls necessary …
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 St. Peter's Hospital from January 1, 2011 through March 31, 2011
… Plan. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … $4,836 from St. Peter’s for the overpayments we identified in this audit. Develop and implement the controls necessary …
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
… 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 Arden Hill Hospital From January 1, 2011 Through March 31, 2011
… Plan. Empire processes Plan claims for hospital services in accordance with agreements they negotiate with member … from Stony Brook for the overpayments we identified in this audit. Develop and implement the controls necessary …
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
… Purpose To determine if Empire BlueCross BlueShield's (Empire's) payments to State University of New York's Stony Brook University … To determine if Empire BlueCross BlueShields Empires payments …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/selected-payments-special-items-made-stony-brook-university-hospital-january-1-2011-throughHudson Falls Central School District - Retiree Insurance Contributions (2018M-18)
… recorded and deposited. We reviewed contributions for 40 retirees, totaling $33,139, and noted minor …
https://www.osc.ny.gov/local-government/audits/school-district/2018/06/01/hudson-falls-central-school-district-retiree-insurance-contributionsUnited HealthCare – Empire Plan Drug Rebates
… Insurance Company of New York (United) credited the Department of Civil Service (Department) for all rebate revenue due under its contract … Determine if United HealthCare Insurance Company of NY credited Department of Civil Service for all rebate revenue due under …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/united-healthcare-empire-plan-drug-rebatesState Agencies Bulletin No. 1140
… be directed to DCS at(518) 457-5754 (Albany Area) or 1 (800) 833-4344 (outside Albany Area). This line is operational …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1140-new-york-state-health-insurance-plan-nyship-opt-out-paymentsUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… New York appropriately reimbursed physician-administered drugs. The audit covered the period from January 2017 through … a range of services, including physician-administered drugs, which are also covered under the Empire Plan’s … paid approximately $878 million for physician-administered drugs. Key Findings We identified $5,536,537 in actual and …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsFour Individuals Charged in Widespread Scheme to Defraud Medicare and Other Health Insurance Providers Through Fraudulent Medical Corporations and False Billing Resulting in Tens of Millions of Dollars in Losses
… scheme through their fraudulent operation of Dolson Avenue Medical ("DAM" or the "Practice"), a multi-disciplinary medical clinic located in Middletown, New York. The … announced the guilty plea of CHARLES BAGLEY, a licensed medical doctor formerly affiliated with DAM and other …
https://www.osc.ny.gov/press/releases/2018/08/four-individuals-charged-widespread-scheme-defraud-medicare-and-other-health-insurance-providersCUNY Bulletin No. CU-597
… Purpose To notify agencies of health benefits rate changes. Affected Employees CUNY employees with health insurance coverage through the City of New York … OSC Actions OSC will automatically implement the bi-weekly health insurance rate changes as requested by the City of New …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-597-city-new-york-health-insurance-rate-changesUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… through December 31, 2016. Background The New York State Health Insurance Program (NYSHIP), administered by the State … Department of Civil Service (Civil Service), provides health insurance coverage to active and retired State, …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryCUNY Bulletin No. CU-478
… Department of Civil Service Employee Benefits Helpline at (800) 833-4344 or (518) 457-5754 to obtain a statement … of Civil Service’s Employee Benefits Helpline at (800) 833-4344 or (518) 457-5754. Questions regarding coverage …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-478-changes-taxation-imputed-incomeUnited HealthCare – Empire Plan Drug Rebate Revenue
… Purpose To determine if United HealthCare (United) remitted all drug rebate revenue to the … Other Related Audits/Reports of Interest United HealthCare Insurance Company of New York: Empire Plan Drug Rebates (2014-S-62) United HealthCare Insurance Company of New York: Empire Plan Drug …
https://www.osc.ny.gov/state-agencies/audits/2016/11/01/united-healthcare-empire-plan-drug-rebate-revenueCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service
… Purpose To determine if CVS Health invoiced and remitted commercial rebate revenue … 2014 through June 30, 2017. Background The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to active and retired State, …
https://www.osc.ny.gov/state-agencies/audits/2019/01/28/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service