Department of Civil Service

New York State Health Insurance Program: Payments to Anesthesiologists

In the New York State Health Insurance Program, the Department of Civil Service administers health insurance programs for active and retired State and local government employees and their dependents. The primary such program is the Empire Plan, which provides services costing more than $2.5 billion a year.

We examined the payments made by the Empire Plan over a three-year period for services provided by anesthesiologists to determine whether any of the services were reimbursed more than once. We identified a number of instances in which the same service was reimbursed more than once and estimated that, during the three-year period, the erroneous payments totaled about $366,000. The erroneous payments were made because, generally, errors in bills submitted by the anesthesiologists were not detected by the Empire Planís insurance carrier. We recommended that the overpayments be recovered, and improvements be made in the bill processing procedures of the insurance carrier.

For a complete copy of Report 2000-S-40 click here.
For a copy of the 90-day response click here.