Search
CVS Health – Accuracy of Drug Rebate Revenue Remitted to the Department of Civil Service (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 benefits plan for NYSHIP, serving 1.1 million members. Civil Service contracted …
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
… Background The New York State Health Insurance Program (NYSHIP), administered by the State Department of Civil … The Empire Plan is the primary health benefits plan for NYSHIP. The Empire Plan provides its members with four types …
https://www.osc.ny.gov/state-agencies/audits/2018/08/13/unitedhealthcare-overpayments-out-network-anesthesia-services-provided-network-ambulatoryState Comptroller DiNapoli Releases Audits
… allocation costs. New York State Health Insurance Program (NYSHIP): Preventing Inappropriate and Excessive Costs in the … reports, auditors determined significant cost savings to NYSHIP would occur if more out-of-network providers who …
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)
… 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, covering 1.1 million members. Civil Service contracts …
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)
… 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 New York State Department of Civil Service …
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)
… 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 New York State Department of Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2015/12/28/empire-bluecross-blueshield-selected-payments-special-items-period-january-1-2012-throughUnited 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-followEmpire BlueCross BlueShield – Controls Over Payments for Special Items
… 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 Empire Plan … State Department of Civil Service (Department) administers NYSHIP. In carrying out its responsibilities, the Department …
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
… renal disease who were eligible for, but not enrolled in, Medicare. The audit covered the period January 1, 2010 … with ESRD. Medicaid recipients with ESRD are eligible for Medicare coverage if they receive regular dialysis treatments … When Medicaid recipients with ESRD are also enrolled in Medicare, Medicare becomes the primary insurer (payer) and …
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
… the Medicaid costs of recipients who were eligible for Medicare based on age but were not enrolled in Medicare. The audit covered the period July 2016 through June …
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 … Background Many Medicaid recipients are also enrolled in Medicare. Such recipients are commonly referred to as …
https://www.osc.ny.gov/state-agencies/audits/2014/05/09/medicaid-program-medicaid-payments-made-pursuant-medicare-part-cMedicaid Payments Made Pursuant to Medicare Part C (Follow-Up)
… in our audit report, Medicaid Payments Made Pursuant to Medicare Part C (Report 2012-S-133). Background Medicaid … of the State’s Medicaid recipients are also enrolled in Medicare. Under Medicare Part C, also known as Medicare …
https://www.osc.ny.gov/state-agencies/audits/2016/12/15/medicaid-payments-made-pursuant-medicare-part-c-followUnitedHealthcare – Improper Payments for Medical Services Designated By Modifier Code 59 (Follow-Up)
… ). 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. The New York State Department of Civil Service …
https://www.osc.ny.gov/state-agencies/audits/2017/12/27/unitedhealthcare-improper-payments-medical-services-designated-modifier-code-59-followEmpire Plan Drug Rebate Revenue
… Background The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to active and … The Department contracted with United to administer the NYSHIP prescription drug program between January 1, 2008 and …
https://www.osc.ny.gov/state-agencies/audits/2014/09/26/empire-plan-drug-rebate-revenueDiNapoli: State Missing Out on Millions in Medicare Payments for Kidney Patients
… (ESRD) who meet certain eligibility requirements get the Medicare benefits to which they are entitled, according to an … with day-to-day life should be informed of their Medicare eligibility, which could reduce their out-of-pocket …
https://www.osc.ny.gov/press/releases/2017/03/dinapoli-state-missing-out-millions-medicare-payments-kidney-patients