New York Medical Providers Reimburse $2.5 Million in Inflated Claims

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February 23, 2010 Tuesday 01:40 PM EST

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New York Medical Providers Reimburse $2.5 Million in Inflated Claims

Sean P Carr

NEW YORK

Six New York State medical providers agreed to reimburse the state nearly $2.5 million and pay $39,107 in fines for inflated billings submitted to the New York State Health Insurance Program.

The medical providers agreed to discontinue the practice of inappropriately waiving out-of-pocket fees that should have been charged to state and local government employees filing health insurance claims. According to the department, the medical providers from New York City and Westchester and Nassau counties passed this cost onto the state.

Audits conducted by State Comptroller Thomas P. DiNapoli discovered the improper claims. The state Department of Civil Service administers the health insurance program, which provides coverage for more than 1.2 million current and former state and local government employees.

The cited providers were: Dr. Edward Fryman; South Shore Ambulatory Center; Fifth Avenue Surgery Center ; Mount Kisco Surgery Center; Mount Kisco Medical Group, Mount Kisco; and Eye Surgery Center of Westchester.

Over the past two years, the state has recovered approximately $11.4 million from providers who submitted inflated claims, according to the insurance department. Investigations are ongoing.

(By Sean P. Carr, Washington Correspondent: [email protected])

February 24, 2010

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