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UnitedHealthcare Insurance Company of New York – Overpayments for Physician-Administered Drugs
… To determine whether UnitedHealthcare Insurance Company of New York appropriately reimbursed physician-administered drugs. …
https://www.osc.ny.gov/state-agencies/audits/2023/09/13/unitedhealthcare-insurance-company-new-york-overpayments-physician-administered-drugsUnitedHealthcare – Overpayments for Out-of-Network Anesthesia Services Provided at In-Network Ambulatory Surgery Centers
… abuse. Civil Service contracts with UnitedHealthcare (United) to administer the medical/surgical portion of the … surgery, physical therapy, and home care services. United processes and pays claims from health care providers … to Empire Plan members, and Civil Service reimburses United for the payments it makes. United contracts with …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryCUNY Bulletin No. CU-597
… Purpose To notify agencies of health benefits rate changes. Affected … Questions regarding this bulletin may be directed to the University Director of Employee Benefits at CUNY …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-597-city-new-york-health-insurance-rate-changesCUNY Bulletin No. CU-478
… same-sex spouse’s health coverage and of the potential tax impact for non-residents of New York State. Affected … health coverage to be taxable as imputed income for NYS tax purposes, regardless of whether the taxpayer was … of a non-employee same-sex spouse's health coverage by NYS to be taxable as imputed income for federal tax purposes, …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-478-changes-taxation-imputed-incomeNew York State Health Insurance Program
All agency audits from 2009 to present.
https://www.osc.ny.gov/files/state-agencies/audits/zip/new-york-state-health-insurance-program.zipUnited HealthCare – Empire Plan Drug Rebate Revenue
… remitted all drug rebate revenue to the Department of Civil Service (Department) as required by the contract … discounts, and other considerations and pass 100 percent of the value of the agreements on to the prescription drug program. For …
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
… rebate revenue related to Empire Plan drug utilization in accordance with its contract with the Department of Civil … prescription drug program costs about $2 billion annually. In accordance with the contract, CVS Health was required to … period, Civil Service received more than $600 million in commercial drug rebates. Key Findings We reviewed the …
https://www.osc.ny.gov/state-agencies/audits/2019/01/28/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-serviceCUNY Bulletin No. CU-356
… in one of the following titles: Graduate Assistant A, B or C Adjunct Instructor Adjunct Lecturer Adjunct College … amount will print on the employee’s paycheck stub or direct deposit advice statement. Code Narrative … York State Department of Civil Service to start, cancel or change rates for individual employees. Agencies will not …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-356-certain-cuny-employees-eligible-new-york-state-healthEmpire Plan Drug Rebate Revenue
… drug rebate and discount revenues from manufacturers are correct and properly credited to the Department, …
https://www.osc.ny.gov/state-agencies/audits/2014/09/26/empire-plan-drug-rebate-revenueMadrid-Waddington Central School District - Claims Audit Process (2019M-1)
… [read complete report - pdf] Audit Objective Determine whether claims were adequately … totaling $886,642 and found the claims auditor did not audit two claims totaling $251,601 for health insurance and … two claims totaling $17,848 were improperly paid prior to audit. The claims auditor did not audit and approve any of …
https://www.osc.ny.gov/local-government/audits/school-district/2019/03/08/madrid-waddington-central-school-district-claims-audit-process-2019m-1UnitedHealthcare – Out-of-Network Providers Upcoding Selected Evaluation and Management Services
… of Civil Service (Civil Service) administers NYSHIP. In carrying out its responsibilities, Civil Service contracts … E/M services. Key Findings Improvements are needed in United’s method for monitoring out-of-network providers …
https://www.osc.ny.gov/state-agencies/audits/2018/12/31/unitedhealthcare-out-network-providers-upcoding-selected-evaluation-and-management-servicesUnited HealthCare – Payments for Fraudulent and Improper Claims Submitted by Davis Ethical Pharmacy
… United HealthCare for prescription medications under the State's employee health insurance program. The audit covered … United more than $6.2 million for 52,485 claims submitted by Davis Ethical. During this period, Davis Ethical was owned and operated by William Davis, a licensed pharmacist. Pursuant to …
https://www.osc.ny.gov/state-agencies/audits/2013/08/13/united-healthcare-payments-fraudulent-and-improper-claims-submitted-davis-ethical-pharmacyUnited HealthCare – Empire Plan Drug Rebate Revenue (Follow-Up)
… status of the recommendation made in our audit report, United HealthCare: Empire Plan Drug Rebate Revenue … Department of Civil Service (Department) contracted with United HealthCare (United) to administer the Empire Plan’s …
https://www.osc.ny.gov/state-agencies/audits/2017/05/15/united-healthcare-empire-plan-drug-rebate-revenue-followUnited HealthCare – Overpayments for Services Provided by Hudson Valley Bone and Joint Surgeons, LLP
… as well as their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering a range of services from inpatient hospital care to outpatient surgical procedures and physician office visits. The New York State Department of …
https://www.osc.ny.gov/state-agencies/audits/2016/09/08/united-healthcare-overpayments-services-provided-hudson-valley-bone-and-joint-surgeons-llpDiNapoli Proposes Option to Help State & Local Governments Pay for Retiree Health Care
… Comptroller Thomas P. DiNapoli today announced legislation to create an optional investment pool to help the state and … rules in place that allow public employers to set aside money today to pay for these benefits,” DiNapoli said. “The … begin making regular annual contributions to a trust and earn a return on investments, it would potentially save …
https://www.osc.ny.gov/press/releases/2015/04/dinapoli-proposes-option-help-state-local-governments-pay-retiree-health-careUnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Follow-Up)
… audit report, UnitedHealthcare Insurance Company of New York: Improper Payments for Acupuncture and Acupuncture-Related Services (Report 2020-S-7 ). About …
https://www.osc.ny.gov/state-agencies/audits/2023/07/20/unitedhealthcare-insurance-company-new-york-improper-payments-acupuncture-and-acupuncturePayments by Beacon Health Options for Mental Health and Substance Abuse Services for Ineligible Members
To determine whether Beacon Health Options paid mental health and substance abuse MHSA claims for Empire Plan members who were not eligible for coverage
https://www.osc.ny.gov/state-agencies/audits/2022/05/13/payments-beacon-health-options-mental-health-and-substance-abuse-services-ineligibleCUNY Bulletin No. CU-799
… Purpose: The purpose of this bulletin is to notify agencies of health benefit rate changes. Affected … Questions regarding this bulletin should be directed to the University Director of Employee Benefits at CUNY Central Office. … The purpose of this bulletin is to notify agencies of health benefit rate changes …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/city-university-new-york/cu-799-city-new-york-health-benefit-rate-changesUnion Springs Central School District – Retiree Health Insurance Contributions (2016M-75)
… the controls over retiree health insurance contributions for the period July 1, 2014 through January 5, 2016. … nine-member Board of Education. Budgeted appropriations for the 2015-16 fiscal year were $17.8 million. Key Finding … of the change, the District will pay more than it should for the insurance coverage. Key Recommendation Enhance …
https://www.osc.ny.gov/local-government/audits/school-district/2016/06/10/union-springs-central-school-district-retiree-health-insuranceNew York State Health Insurance Program – Payments by UnitedHealthcare for Medical/Surgical Services for Ineligible Members
… with UnitedHealthcare Insurance Company of New York (United) to administer the medical/surgical portion of this plan. From January 1, 2014 through December 31, 2019, United processed and paid over $16.6 billion in … and Accounting System (NYBEAS). Civil Service sends United daily files of NYBEAS eligibility changes and United …
https://www.osc.ny.gov/state-agencies/audits/2021/09/29/new-york-state-health-insurance-program-payments-unitedhealthcare-medicalsurgical-services