Department of Civil Service
New York State Health Insurance Program: Coordination of Medicare Coverage (Follow-up Review) In our prior audit 98-S-17, we found that because of weaknesses in the Empire Plan's system for identifying Medicare eligibility, Empire Blue Cross Blue Shield (Empire Blue Cross) and United HealthCare Service Corporation (UHC) paid claims totaling $1.7 million, which Medicare should have paid. In our follow-up review, we found that Empire Blue Cross officials recovered $887,000, which falls within the dollar range of claims estimated that Medicare should have paid. UHC officials recovered $278,000, which is significantly less than the dollar range of claims we estimated that Medicare should have paid.
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