Department of Civil Service

New York State Health Insurance Program: Coordination of Medicare Coverage

The Department of Civil Service administers health insurance programs for State and local government employees and their dependents. The primary program in the New York State Health Insurance Program is the Empire Plan, which provides services costing about $1.6 billion a year. We examined the hospitalization and major medical claims paid during 1997 by the Empire Plan on behalf of people who were eligible for Medicare and estimate that about $1.7 million of these claims should have been paid by Medicare. We recommend that these payments be recovered from the appropriate parties, and improvements be made in the Empire Plan's procedures for identifying enrollees who are eligible for Medicare.

For a complete copy of Report 98-S-17 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.