The HHS Inspector General’s office is organized into the following divisions. You can learn more by clicking on the link to the division’s page.
The Audit Division conducts risk-based audits of contractors, providers, and HHS programs to reduce fraud, waste, and abuse throughout the HHS System.
The Chief Counsel Division provides dedicated attorneys for the Audit, Investigations, Inspections and Medical Services divisions, and advises the IG on a wide array of complex topics centered on our mission to pursue and take effective action against fraud, waste, and abuse.
The Inspections Division conducts inspections of HHS programs, systems, or functions focused on systemic issues. It provides practical recommendations to improve effectiveness and efficiency to prevent fraud, waste, and abuse. The Investigations Division protects the integrity of HHS programs through investigations of employee misconduct, contract and recipient fraud, waste, and abuse; to include, but not limited to bribery, theft, and egregious acts against the HHS system and programs.
The Benefits Program Integrity Division works to protect the integrity of the Texas Medicaid system and other HHS programs by investigating allegations of recipient fraud, waste, and abuse.
Medicaid Program Integrity (MPI) investigates allegations of fraud, waste, and abuse committed by Medicaid providers. MPI makes referrals to the Attorney General's Medicaid Fraud Control Unit when there are indicators of criminal Medicaid fraud. The Medical Services group of MPI identifies and recovers inappropriate Medicaid billing by analyzing Medicaid fee-for-service claims and managed care encounter data, conducting medical policy research, and performing review activities. The group also provides clinical professional consultation to other OIG staff in physician, nursing, dentistry, and pharmacy.
These divisions help other IG divisions achieve their goals of detecting and deterring fraud, waste, and abuse in Texas Health and Human Services System programs.
- Operations: This division promotes a culture of collaboration, innovation, and accountability throughout the IG by enhancing efficiency and effectiveness, and promoting responsibility.
- Chief Strategy Office: This division includes a data and technology team and a group of policy experts and staff with managed care and contract knowledge. The Data and Technology group implements tools, solutions, and innovative data analytic techniques to streamline operations and increase the identification of fraud, waste, and abuse. The Policy and Publications group analyzes legislation and HHS program policies and ensures timely and effective external communication and outreach with a variety of stakeholders.