Four of New York state’s largest ambulatory surgery centers reportedly waived out-of-pocket fees for members of the government-employee health plan and then covered some $8 million in additional costs by sending inflated charges to the state’s insurance administrator, UnitedHealthcare, according to audits released by the office of New York State Comptroller Thomas DiNapoli.
Auditors from DiNapoli’s office examined medical claims from January 2001 through December 2006, and recommended that Minnetonka, Minn.-based UnitedHealthcare recover the $8 million from the providers and that it work with the state’s Department of Civil Service to develop a plan to prevent this from occurring again. DiNapoli said in a news release that similar audits are already in progress.
In the audits released Dec. 3, Napoli said that the Endoscopy Center of Long Island, Garden City, was overpaid $2.7 million; Capital Region Ambulatory (orthopedic) Surgery Center, Albany, was overpaid $2.4 million; Digestive Health Center of Huntington (N.Y.) was overpaid $1.5 million; and Day-Op Center of Long Island, Mineola, was overpaid $1.4 million.
A representative from the New York State Association of Ambulatory Surgery Centers could not be reached for comment.
UnitedHealthcare released a statement saying that it would work with the state to pursue recovery of the money and that it was taking additional measures to assure that no other providers in the New York State Health Insurance Program’s Empire Plan are doing the same things. -- by Andis Robeznieks
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