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DiNapoli: Former Pharmacist Pleads Guilty In $232,000 Fake Prescriptions Scam
… 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)
… June 30, 2011 (2011-S-42). Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, … BlueShield (Empire) to administer the hospitalization benefit portion of the Plan. Empire processes and pays claims …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… of Drug Rebate Revenue Remitted to the Department of Civil Service (Report 2019-S-51 ). About the Program The New York … Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance coverage to over 1.2 … of Drug Rebate Revenue Remitted to the Department of Civil Service Report 2019S51 …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followNew York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Follow-Up)
… and school district employees, and their dependents. The Empire Plan is the primary health insurance plan for NYSHIP, … Civil Service contracts with UnitedHealthcare Insurance Company of New York (United) to administer the Empire Plan’s medical/surgical benefits. Civil Service is …
https://www.osc.ny.gov/state-agencies/audits/2023/01/18/new-york-state-health-insurance-program-payments-unitedhealthcare-medicalsurgical-servicesEmpire BlueCross – Overpayments for Physician-Administered Drugs
… contracts with Empire BlueCross (Empire) to administer the Hospital Program of the Empire Plan. Empire processes and pays claims for hospital services, which includes coverage for inpatient and outpatient services provided by a hospital, skilled nursing facility, or hospice. These …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/empire-bluecross-overpayments-physician-administered-drugsState Comptroller DiNapoli Releases State Audits and Examinations
… obligations for services provided. The Empire Plan is the primary health benefits plan for NYSHIP. The New York State … (United) to process and pay medical claims from health care providers for services provided to Empire Plan members. …
https://www.osc.ny.gov/press/releases/2017/03/state-comptroller-dinapoli-releases-state-audits-and-examinationsEmpire BlueCross – Overpayments for Physician-Administered Drugs (Follow-Up)
… coverage. Civil Service contracts with Anthem Blue Cross (Anthem), formerly Empire BlueCross, to administer the …
https://www.osc.ny.gov/state-agencies/audits/2025/06/04/empire-bluecross-overpayments-physician-administered-drugs-followUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… overpaid for out-of-network anesthesia services provided at Ambulatory Surgery Centers that were contractually … health care providers who agree to accept payments, at rates established by United, to furnish medical/surgical … all anesthesia services provided to Empire Plan members at their facilities to be performed by in-network providers. …
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)
… recommendations made in our audit report, New York State Health Insurance Program: Empire BlueCross BlueShield … 2012 (Report 2012-S-132). Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and retired State, …
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)
To determine the extent of implementation of 3 recommendations made in our audit report NYS Health Insurance Program Empire BlueCross BlueShield Selected Paym
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)
… (NYSHIP) provides health insurance coverage to active and retired State, participating local government, and school … to administer the Plan’s prescription drug program between January 1, 2008 and December 31, 2013. United subcontracted … including the negotiation, collection, and allocation of rebates offered by drug manufacturers. In 2012, Express …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
To assess the extent of implementation of the four recommendations included in our initial audit report New York State Health Insurance Program Payments by Beacon Health Options for Mental Health and Substance Use Services for Ineligible Members Report 2021S18
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andState Comptroller DiNapoli Releases Audits
… and Child Learning Center (ICLC) - The Research Foundation for the State University of New York: Compliance with the Reimbursable Cost Manual (2017-S-22) For the three fiscal years ended June … of Security Expenses in Single Adult and Adult Family Homeless Shelters (2016-N-6) The city’s Department of …
https://www.osc.ny.gov/press/releases/2018/06/state-comptroller-dinapoli-releases-auditsUnited HealthCare Insurance Company of New York – Empire Plan Drug Rebates (Follow-Up)
… the two recommendations made in our audit report, United HealthCare Insurance Company of New York: Empire Plan Drug … of Civil Service (Department) contracted with United HealthCare (United) to administer the Empire Plan’s … Interest New York State Health Insurance Program: United HealthCare Insurance Company of New York - Empire Plan Drug …
https://www.osc.ny.gov/state-agencies/audits/2017/05/24/united-healthcare-insurance-company-new-york-empire-plan-drug-rebates-followUnitedHealthcare: Improper Payments for Acupuncture and Acupuncture-Related Services
… provided at the same time as other services, including heat therapy, massage therapy, electrical stimulation, and …
https://www.osc.ny.gov/state-agencies/audits/2021/10/27/unitedhealthcare-improper-payments-acupuncture-and-acupuncture-related-servicesUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs (Follow-Up)
… Plan and to process and pay claims submitted by health care providers. Medical/surgical benefits cover a range of … The audit covered the period from January 2017 through December 2021. We identified over $5.5 million in actual and … to assess the extent of implementation, as of March 18, 2025, of the eight recommendations included in our initial …
https://www.osc.ny.gov/state-agencies/audits/2025/05/21/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsUnited HealthCare – Empire Plan Drug Rebates
… Purpose To determine if United HealthCare Insurance Company of New York (United) credited the Department of Civil Service (Department) for all rebate revenue due … 1, 2011 through December 31, 2013 and included a review of revenue from five drug manufacturers. Background The New …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/united-healthcare-empire-plan-drug-rebatesEmpire BlueCross BlueShield – Payments to John T. Mather Memorial Hospital (Follow-Up)
… John T. Mather Memorial Hospital (Mather). Empire’s agreement with the Health Network allows the hospitals to be … items claimed by Mather were appropriate. Empire’s agreement with the Health Network did not define the amount … items, and Empire paid these excessive amounts. The agreement between Empire and the Health Network also …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/empire-bluecross-blueshield-payments-john-t-mather-memorial-hospital-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… payments which result from contracts with hospitals that do not include language that limits the reimbursement of … payment amounts for special items; however, some contracts do not have similar limitations. As of December 31, 2016, …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsState Agencies Bulletin No. 2232
… is to inform agencies of OSC’s automatic processing of the PEF 2024 Dental Stipend and to provide agency instructions … the 2023-2026 Agreement between the State of New York and PEF which includes a side letter authorizing a $400 lump sum … Effective Dates: OSC will automatically process the PEF 2024 Dental Stipend for certain eligible employees using …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2232-public-employees-federation-pef-2024-dental-stipend