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.