NEW: Protocols for Texas Medicaid fee-for-service Vendor Drug Program audits.

In order to help identify and reduce fraud, waste, and abuse, the IG Audit Division conducts risk-based performance, provider, and information technology audits related to (a) the accuracy of medical provider payments, (b) the performance of Health and Human Services (HHS) agency contractors, and (c) programs, functions, processes, and systems within the HHS System. Protocols of provider audits will be periodically published on the Resources page.

In addition to performing audits, the Audit Division coordinates all federal government audits, manages the Recovery Audit Contractor (RAC) contract, and serves as the single point of contact with the Centers for Medicare and Medicaid Services for Medicaid Integrity Contractor (MIC) audits and Payment Error Rate Measurement (PERM) activities.

Note:  Final audit reports are posted to the IG website when issued. These reports are subject to appeal upon timely, written, proper requests for appeal, as provided for in rule. These final audit reports are public records and remain posted on the website during and after an appeal.

For more information on Audit Division projects, processes, and initiatives, please review:

Two-Year Rolling Audit Plan, updated April 2017.

Audit Process Overview

Audit Division Risk Assessment

External quality assurance review letter, issued January 2017.

Resources for providers