New York’s highest court on Tuesday is scheduled to hear arguments on behalf of a group of doctors who contend that Comptroller Tom DiNapoli doesn’t have the authority to audit their billing records in connection with insurance policies that cover public employees.
The case dates to earlier audits in which DiNapoli contended that two Long Island health care providers — cardiologist Marvin H. Handler and South Island Orthopaedic Group— had essentially inflated their billings by not charging the customary 20 percent co-pays to patients.
Neither medical practice was a “participating” member of the Empire Plan, a major public sector health care insurer. Because they didn’t charge the co-pay, United Healthcare, which contracts with Empire to run the plan, was overpaying the doctors, according to the comptroller.
Auditors concluded that Handler had been overpaid approximately $900,000 and South Island $800,000 and that United should attempt to recover that money.
The doctors, though, fought back, halting efforts to collect the money and arguing in court that the comptroller didn’t have the right to audit them since they were, according to a Court of Appeals summary, “private entities that do not directly receive state funds.”
A trial court agreed, but an Appellate Division court reversed that, saying “United is reimbursed in full with state funds.”
The comptroller’s office declined comment, saying they don’t talk about pending litigation.
In another case that could have broad implications, the Court of Appeals on Wednesday is set to hear arguments regarding disclosure of teacher pensions.
The Empire Center, a think tank that posts public data such as public payrolls, is seeking information about the Teachers Retirement systems for New York City and the rest of the state.
Lower courts, citing privacy issues, have upheld the retirement systems’ denial of Freedom of Information Law requests for names of retirees and the amount of their publicly funded pensions.
The Empire Center, according to a Court of Appeals release, has argued those denials amount to an overly narrow misreading of an earlier court decision regarding retired police.
© 2014, Albany Times Union