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NYSHIP recovers more than $9 million dollars paid for inflated medical claims

NYSHIP recovers more than $9 million dollars paid for inflated medical claims
Office of the State Comptroller: Press Release

State Comptroller Thomas P. DiNapoli has issued a press release indicating that more than $9 million has been recovered from non-participating medical providers charged with abusing the New York State Health Insurance Program.

NYSHIP?s health insurance program is second only to the Federal Government in size in the nation and provides health insurance to more than 1.2 million current and former state and local government employees.

The release reports that twenty non-participating medical providers submitted inflated claims to the New York State Health Insurance Program (NYSHIP) after they inappropriately waived out-of-pocket costs for state and local government employees, costing NYSHIP nearly $14 million. The New York State Insurance Department and the New York State Department of Civil Service thus far have recovered more than $9 million in over-billings and fines from five of these non-participating providers.

DiNapoli?s auditors are also working with the New York State Insurance Department?s Frauds Bureau and United Healthcare, which administers the Empire Plan, to recover any overpayments from providers who have submitted inflated bills. Additional audits of NYSHIP are currently underway.

The full text of the Comptroller?s report is posted on the Internet at:

http://www.osc.state.ny.us/audits/allaudits/093008/08s130.pdf

A list of 20 of the 22 non-participating providers submitting invalid bills to the New York State Health Insurance Program is posted on the Internet at:

http://www.osc.state.ny.us/press/releases/oct08/nyshiplist.pdf

Full post as published by New York Public Personnel Law on October 28, 2008 (boomark / email).