Department of Civil Service
New York State Health Insurance Program: Coordination of Medicare Coverage - 1998 Claims Our audit survey revealed that the enrollment system implemented for the New York State Health Insurance Program's Empire Plan (Plan) does not always capture Medicare eligibility information for Plan members. As a result, we estimate that Empire Blue Cross Blue Shield and United HealthCare Service Corporation paid claims totaling $1.8 million that should have been paid by Medicare. Empire Blue Cross officials agreed, and have already recovered $619,250 of the $1,090,000 we identified and are actively pursuing the remaining claims. United HealthCare officials generally agreed with our overpayment estimate.
For a complete copy of Report 99-S-14 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.