Search
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 when the …
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 hospital services are generally based on standard fee schedules. However, hospitals may be entitled … for special items, while agreements with other hospitals do not have such limitations. From April 1, 2011 to June 30, 2011, …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughNew York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Follow-Up)
… in our initial audit report, Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members (Report 2020-S-34 ). About the Program … The Empire Plan is the primary health insurance plan for NYSHIP, covering 1.1 million members. Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2023/01/18/new-york-state-health-insurance-program-payments-unitedhealthcare-medicalsurgical-servicesState Comptroller DiNapoli Releases State Audits and Examinations
… following audits and examinations have been issued: Office of Temporary and Disability Assistance (OTDA): Wage Subsidy … Joint routinely waived Empire Plan members' required out-of-pocket cost-sharing obligations for services provided. The … benefits plan for NYSHIP. The New York State Department of Civil Service contracts with United HealthCare (United) to …
https://www.osc.ny.gov/press/releases/2017/03/state-comptroller-dinapoli-releases-state-audits-and-examinationsCVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Follow-Up)
… included in our initial audit report, Accuracy of Drug Rebate Revenue Remitted to the Department of Civil … CVS Health to administer the Empire Plan’s prescription drug program for the period from January 1, 2014 through … CVS Health was required to negotiate agreements with drug manufacturers for rebates and remit the rebate revenue …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followEmpire BlueCross – Overpayments for Physician-Administered Drugs
… incorrectly processed by Empire whereby Empire paid the full price even though the facility billed $0.01 (no-cost); …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/empire-bluecross-overpayments-physician-administered-drugsUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… extent of implementation of the three recommendations made in our initial audit report, United HealthCare Insurance … and allocation of rebates offered by drug manufacturers. In 2012, Express Scripts Holding Company (Express Scripts) … was issued on September 26, 2014, identified $694,227 in drug rebate and discount revenue that was not credited to …
https://www.osc.ny.gov/state-agencies/audits/2015/12/03/united-healthcare-empire-plan-drug-rebate-revenue-followEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Follow-Up)
… Our initial audit report, which was issued on January 16, 2014, found that Empire did not have adequate controls to …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-july-1-2012-throughEmpire 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-throughNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
… Objective To assess the extent of implementation of the four recommendations included in our initial audit … Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), provides health insurance … To assess the extent of implementation of the four recommendations included in our …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andEmpire BlueCross – Overpayments for Physician-Administered Drugs (Follow-Up)
… Empire BlueCross – Overpayments for Physician-Administered Drugs (Report 2021-S-33 ). About the Program The New York … cover a range of services including physician-administered drugs, which are drugs administered by health care professionals in a hospital … Empire BlueCross Overpayments for PhysicianAdministered Drugs Report 2021S33 …
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
… 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-ambulatoryState Comptroller DiNapoli Releases Audits
… costs. Department of Health (DOH): Examination of Official Station Designation (2015-BSE1-04) DOH’s designation of the official station for an employee in calendar years 2013 and 2014 was … rules and regulations. As a result of an improper official station designation, DOH paid $16,089.56 and $22,033.71 in …
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)
… Purpose To determine the implementation status of the two recommendations made in our audit report, United … Empire Plan Drug Rebates (Report 2014-S-62). Background The New York State Health Insurance Program (NYSHIP) provides … To determine the implementation status of 2 recommendations made in our …
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
… The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. Civil Service … dollars, that were not supported by documentation. Based on a projection of the sample to the audit population for the … $223,765 in duplicate payments for services already paid on another claim, including $18,663 confirmed by United and …
https://www.osc.ny.gov/state-agencies/audits/2021/10/27/unitedhealthcare-improper-payments-acupuncture-and-acupuncture-related-servicesUnited 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-rebatesEmpire BlueCross BlueShield – Payments to John T. Mather Memorial Hospital (Follow-Up)
… were implemented. 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: Empire BlueCross Blue Shield - Payments to …
https://www.osc.ny.gov/state-agencies/audits/2013/06/04/empire-bluecross-blueshield-payments-john-t-mather-memorial-hospital-followUnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs (Follow-Up)
… (Report 2021-S-32 ). About the Program The New York State Health Insurance Program (NYSHIP), administered by the … prescription drug, medical/surgical, hospital, and mental health and substance abuse coverage. Civil Service … Plan and to process and pay claims submitted by health care providers. Medical/surgical benefits cover a range of …
https://www.osc.ny.gov/state-agencies/audits/2025/05/21/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… Purpose To determine if Empire BlueCross BlueShield: implemented sufficient controls … and school district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The Empire Plan covers a comprehensive range of services …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsState Agencies Bulletin No. 2232
… employee’s taxable gross, and reported on the employee’s Form W-2. Federal, State, and New York City income tax … payroll check, OSC will accept a photocopy of this form along with a new Report of Check Exchange Questions: …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/2232-public-employees-federation-pef-2024-dental-stipend