N.Y. Comptroller: Fraud in State Health Program
State Comptroller Thomas DiNapoli says 20 medical providers cost New York nearly $14 million by intentionally not collecting out-of-pocket payments state workers should have made to the state health insurance program.
Because the physician groups weren’t participants in the Empire Plan — the primary health insurance plan for state employees — workers were responsible for paying a greater share of their out-of-network medical bills.
But doctors waived collecting those higher payments to attract more patients and to receive reimbursements up to 80 percent higher than providers in the plan are paid.
DiNapoli says the problem is likely widespread. His office evaluated 22 providers and only two hadn’t inappropriately waived patient costs.
Copyright 2024 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Popular Today
- California Chiropractor Sentenced to 54 Years for $150M Workers’ Comp Scheme
- EPA Designates PFAS Chemicals as Superfund Hazardous Substances
- Beyond the Claim: How Social Canvassing is Transforming Insurance Fraud Detection
- California Sees Two More Property Insurers Withdraw From Market
Popular This Month
- Report: Vehicle Complexity, Labor ‘Reshaping’ Auto Insurance and Collision Repair
- Millions of Recalled Hyundai and Kia Vehicles, With Dangerous Defect, Remain on Road
- Mother of 8-Year-Old ‘Violently Sucked’ into Houston Hotel Pool Files Wrongful Death Suit
- Poll: Consumers OK with AI in P/C Insurance, but Not So Much for Claims and Underwriting