The Strategy and Audit Division includes the Data and Technology (DAT), Audit and Policy Advancement units.

DAT implements tools and innovative data analytic techniques that streamline OIG operations and increase the identification of fraud, waste and abuse. DAT assesses trends and patterns regarding behavior of providers, clients and retailers participating in Texas Health and Human Services (HHS) programs. DAT consists of four units:

  • Fraud Analytics is responsible for data curation processes, creating complex algorithms, integrating data into usable datasets and conducting data analysis to identify trends and patterns of provider and client behavior and billing practices.
  • Data Research & Analysis performs all data queries and analysis, data validation and population development using various data systems, which includes coordinating with external partners and payers for the Audit unit and Inspections and Investigations Division. This unit also is also responsible for geomapping, link analysis functions, data visualization, and risk analysis and the development of reports for submission to OIG divisions.
  • Statistical Analysis provides sampling and extrapolation support to the Audit unit and Inspections and Investigations Division and the design and development of statistical models for the OIG.
  • Data Operations oversees data project management functions, business intelligence solutions and providing data system support to the OIG.

Audit conducts risk-based audits related to the accuracy of medical provider payments; the performance of HHS agency contractors; and programs, functions, processes, and systems within the HHS system. Protocols of provider audits are periodically published on the Resources page on the OIG’s website. Audit also coordinates all federal government audits of the HHS System.

The Policy Advancement Unit serves as the health care policy subject matter expert and liaison across the OIG. The unit conducts analysis of program policies and coordinates and ensures timely and effective communication with a variety of stakeholders.

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.

Document links

Rolling Audit Plan, updated February 2019.

Audit Process Overview

OIG Audit Division Overview   Print-and-fold version

Audit Division Risk Assessment

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

External quality assurance review letter, issued August 2019.

External quality assurance review letter, issued January 2017.

Resources for providers