Audit recommends strengthening contract oversight

The OIG conducted an audit of MCNA Insurance Company (MCNA Texas), a Texas Medicaid and CHIP Dental Maintenance Organization (DMO). The audit objective was to evaluate the effectiveness of MCNA Texas performance in complying with selected contract requirements, achieving related contract outcomes, and reporting financial and performance results to Texas Health and Human Services (HHS).

The audit found unallowable, unsupported or overstated expenses. The OIG recommended Medicaid and CHIP Services (MCS) strengthen contract oversight and financial monitoring, as well as require MCNA Texas to address and correct its expense reporting to HHS. The report also included recommendations to ensure (a) MCNA Texas fees paid to affiliates comply with contractual requirements and (b) affiliate profits are appropriately reported to HHS.

Read the report and MCNA’s response in the full audit.