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CVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service
… of Civil Service. Our audit covered the period January 1, 2014 through June 30, 2018. About the Program The New York … Service), provides health insurance coverage to over 1.2 million active and retired State, participating local … primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Civil Service contracted with CVS Health …
https://www.osc.ny.gov/state-agencies/audits/2019/06/06/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-serviceCVS Health – Accuracy of Empire Plan Medicare Rx Drug Rebate Revenue Remitted to the Department of Civil Service
… district employees, and their dependents. The Empire Plan is the primary health benefits plan for NYSHIP, covering … who are dual enrolled in the Empire Plan and Medicare have their prescription drug coverage under Empire Plan … Civil Service. We identified $10,723,916 in rebates that is due Civil Service from CVS Health. Key Recommendations …
https://www.osc.ny.gov/state-agencies/audits/2023/06/21/cvs-health-accuracy-empire-plan-medicare-rx-drug-rebate-revenue-remitted-department-civilState Agencies Bulletin No. 307
… Purpose To explain the use of the new deduction code 321, MedAmerica … Program. Affected Employees All employees who are eligible to participate in the New York State Health Insurance …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/307-new-insurance-program-medamerica-long-term-care-insuranceEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… Purpose To determine if Empire BlueCross BlueShield: implemented … over the identification and recovery of overpayments made to hospitals for special medical items; and took sufficient … million in excessive payments that were not recoverable due to limitations in Empire’s hospital contracts. To correct …
https://www.osc.ny.gov/state-agencies/audits/2017/06/22/empire-bluecross-blueshield-controls-over-payments-special-itemsCVS Health – Temporary Holding Account Rebate Revenue
… Objective To determine if CVS Health remitted to the State Department … We identified $428,958 in rebate revenue that is due to Civil Service for rebate-eligible claims in the … December 31, 2018. CVS Health agreed Civil Service is due the additional rebates. CVS Health also agreed to remove …
https://www.osc.ny.gov/state-agencies/audits/2019/10/17/cvs-health-temporary-holding-account-rebate-revenueGeddes Town Clerk Charged in $30K Swindle
… records that she had declined the coverage in order to fraudulently receive $6,000 from the town meant for … addition, Carhart cost the town another $30,000 by failing to pay her actual health insurance premiums and leaving the town to pay the bill. “Ms. Carhart hoodwinked Geddes town …
https://www.osc.ny.gov/press/releases/2019/04/geddes-town-clerk-charged-30k-swindleComptroller DiNapoli Releases Municipal Audits
… found that the board did not adopt information technology (IT) security policies and procedures. In addition, the board … of the court records and reports was inadequate. Find out how your government money is spent at Open Book New York . Track municipal spending, …
https://www.osc.ny.gov/press/releases/2020/01/comptroller-dinapoli-releases-municipal-audits-1Empire BlueCross BlueShield Selected Payments for Special Items for the Period January 1, 2011 Through March 31, 2011
… actual purchase and acquisition costs. Background The New York State Health Insurance Program (NYSHIP) provides health … and retired State, participating local government and school district employees and their dependents. The …
https://www.osc.ny.gov/state-agencies/audits/2013/02/01/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2011-throughUnitedHealthcare: Improper Payments for Acupuncture and Acupuncture-Related Services
… Objective To determine whether UnitedHealthcare Insurance Company of New York appropriately reimbursed … December 31, 2019. About the Program The New York State Health Insurance Program (NYSHIP), administered by the … 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-servicesSouth Kortright Central School District – Retiree Health Insurance Contributions (2016M-148)
… Purpose of Audit The purpose of our audit was to determine the adequacy of District controls over the … not prepared a reconciliation of the estimated premiums to the actual amounts so that the estimated billings can be … proper amounts are billed. Design a reconciliation process to accurately adjust the initial retiree billings based on …
https://www.osc.ny.gov/local-government/audits/school-district/2016/07/08/south-kortright-central-school-district-retiree-health-insurancePublic Health – 2021 Financial Condition Report
… (17.8 percent) to $4.6 billion. In SFY 2020-21, federal funds covered 98.6 percent or $4.5 billion in Essential Plan costs, with State funds covering the remaining 1.4 percent. Nearly 8.4 Million …
https://www.osc.ny.gov/reports/finance/2021-fcr/public-healthBroadalbin-Perth Central School District – Health Insurance Buyouts and Separation Payments (2014M-146)
… Purpose of Audit The purpose of our audit was to examine the adequacy and support for the District’s …
https://www.osc.ny.gov/local-government/audits/school-district/2014/08/15/broadalbin-perth-central-school-district-health-insurance-buyouts-andState Comptroller DiNapoli Releases Audits
… New York State Comptroller Thomas P. DiNapoli announced today the following audits have been issued. Department of Health – Improper Medicaid Payments for Outpatient Services Billed as Inpatient Claims (Follow-Up) (2024-F-26) A recipient’s status in a hospital—inpatient …
https://www.osc.ny.gov/press/releases/2025/04/state-comptroller-dinapoli-releases-auditsEmpire BlueCross BlueShield – Selected Payments for Special Items for the Period April 1, 2011 Through June 30, 2011 (Follow-Up)
… Purpose To determine the extent of implementation of the three … Program (NYSHIP) provides health insurance coverage to active and retired State, participating local government …
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 – Empire Plan Members With Dual Family Coverage (Follow-Up)
… Objective To assess the extent of implementation of the two recommendations included in our initial audit report, New York State Health Insurance … and their spouse/domestic partner are both eligible to enroll in NYSHIP, only one may elect Family coverage (the …
https://www.osc.ny.gov/state-agencies/audits/2022/09/26/new-york-state-health-insurance-program-empire-plan-members-dual-family-coverage-followPublic Health – 2023 Financial Condition Report
… restrictions on disenrollment during the COVID public health emergency. Federal restrictions during the pandemic … Yorkers Benefited from Medicaid, Essential Plan or Child Health Plus In March 2023, nearly 9.4 million individuals or … were enrolled in Medicaid, the Essential Plan or Child Health Plus (which provides coverage for children under the …
https://www.osc.ny.gov/reports/finance/2023-fcr/public-healthPublic Health – 2022 Financial Condition Report
… Medicaid spending grew by $5.2 billion (22.9 percent) to $27.7 billion in SFY 2021-22, its highest level ever, due in part to higher enrollment levels impacted by federal … by the end of March 2022, the highest level ever, largely due to federal restrictions on disenrollment during the …
https://www.osc.ny.gov/reports/finance/2022-fcr/public-healthCVS 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 … audit report, Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (Report 2019-S-51 ). About … to which it was entitled. As a result, Civil Service was due $453,029 in rebate revenue for the period of January 1, …
https://www.osc.ny.gov/state-agencies/audits/2021/11/16/cvs-health-accuracy-drug-rebate-revenue-remitted-department-civil-service-followEssential Plan – Federal Funding and New York
… New York is one of three states to have a “basic health plan,” as authorized by the Affordable Care Act ; in New York, this is known as the Essential Plan (EP). The EP provides health insurance to individuals …
https://www.osc.ny.gov/reports/budget/fed-funding-ny/essential-planUnited HealthCare – Overpayments for Services Provided by Long Island Laparoscopic Surgery
… Purpose To determine whether Long Island Laparoscopic Surgery, PLLC waived Empire Plan …
https://www.osc.ny.gov/state-agencies/audits/2016/05/05/united-healthcare-overpayments-services-provided-long-island-laparoscopic-surgery