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Empire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… report, Empire BlueCross BlueShield: Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 … The Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service contracts with …
https://www.osc.ny.gov/state-agencies/audits/2014/10/30/empire-bluecross-blueshield-selected-payments-special-items-period-april-1-2011-throughState Comptroller DiNapoli Releases State Audits and Examinations
… Programs (Follow-Up) (2017-F-1) An initial audit released in March 2016 found OTDA needed to develop a system to more … program milestones, goal achievement, and wage subsidies. In a follow-up, auditors found OTDA officials have made significant progress in addressing the problems identified in the initial audit. …
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)
… Objective To assess the extent of implementation of the two recommendations … of Drug Rebate Revenue Remitted to the Department of Civil Service (Report 2019-S-51 ). About the Program The New …
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
… the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service … The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million of these members. Civil …
https://www.osc.ny.gov/state-agencies/audits/2023/09/27/empire-bluecross-overpayments-physician-administered-drugsUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… To determine whether UnitedHealthcare overpaid for out-of-network anesthesia services provided at Ambulatory Surgery … Program (NYSHIP), administered by the State Department of Civil Service (Civil Service), provides health insurance … health care providers who agree to accept payments, at rates established by United, to furnish medical/surgical …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryState Comptroller DiNapoli Releases Audits
… Services (DSS): Oversight of Security Expenses in Single Adult and Adult Family Homeless Shelters (2016-N-6) The city’s …
https://www.osc.ny.gov/press/releases/2018/06/state-comptroller-dinapoli-releases-auditsNew York State Health Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members (Follow-Up)
… Insurance Program – Payments by Beacon Health Options for Mental Health and Substance Use Services for Ineligible … the change in eligibility takes effect, it is considered a retroactive disenrollment. Civil Service provides Carelon … overpayments for services, which resulted primarily from retroactive disenrollments. Key Findings Civil Service and …
https://www.osc.ny.gov/state-agencies/audits/2024/01/03/new-york-state-health-insurance-program-payments-beacon-health-options-mental-health-andUnited Healthcare – Empire Plan Drug Rebate Revenue (Follow-Up)
… ). Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Plan covers many health care services, including …
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)
… Program: Empire BlueCross BlueShield Selected Payments for Special Items for the Period July 1, 2012 Through December 31, 2012 (Report … additional payments for special items (implants, drugs and blood) that are not covered by the standard fee schedules. …
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)
… Program: Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2012 Through June 30, 2012 (Report … additional payments for special items (implants, drugs and blood) that are not covered by the standard fee schedules. …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughEmpire BlueCross – Overpayments for Physician-Administered Drugs (Follow-Up)
… of the seven recommendations included in our initial audit report, Empire BlueCross – Overpayments for Physician-Administered Drugs (Report 2021-S-33 ). About …
https://www.osc.ny.gov/state-agencies/audits/2025/06/04/empire-bluecross-overpayments-physician-administered-drugs-followUnited HealthCare Insurance Company of New York – Empire Plan Drug Rebates (Follow-Up)
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to about 1.2 … The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The New York State …
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 Program The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service … The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2021/10/27/unitedhealthcare-improper-payments-acupuncture-and-acupuncture-related-servicesUnited HealthCare – Empire Plan Drug Rebates
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. The Department …
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)
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … Empire Plan (Plan) is the primary health benefits plan for NYSHIP. The Department of Civil Service (Department) …
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)
… the Program The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service … The Empire Plan is the primary health insurance plan for NYSHIP, providing over 1 million members with four types 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
… item payments for implants, having ended its corresponding vendor contract. For special item implant claims processed …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsMedicaid Program – Reducing Medicaid Costs for Recipients With End Stage Renal Disease
… Purpose To determine whether the Department of Health took sufficient steps to control the Medicaid costs of recipients diagnosed with …
https://www.osc.ny.gov/state-agencies/audits/2017/03/01/medicaid-program-reducing-medicaid-costs-recipients-end-stage-renal-diseaseMedicaid Program – Reducing Medicaid Costs for Recipients Who Are Eligible for Medicare
… and practitioner claims that could have been covered by Medicare as the primary payer had the recipients been …
https://www.osc.ny.gov/state-agencies/audits/2023/09/14/medicaid-program-reducing-medicaid-costs-recipients-who-are-eligible-medicareMedicaid Program – Medicaid Payments Made Pursuant to Medicare Part C
… To determine if Medicaid made excessive payments for Medicare Part C cost-sharing liabilities. The audit covered … enrolled in Part C. Key Recommendations Re-evaluate the reimbursement methodology for Medicare Part C cost-sharing, …
https://www.osc.ny.gov/state-agencies/audits/2014/05/09/medicaid-program-medicaid-payments-made-pursuant-medicare-part-c