About IG Audit reports

February 2018 Audit

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.

The audit evaluated Southside Pharmacy to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued February 9, 2018.

The audit evaluated whether fee-for-service claims for incontinence supplies paid with Medicaid funds were billed in accordance with state laws, regulations, and program requirements.  Test results indicated no exceptions. Issued December 20, 2017.

This audit evaluated whether claims for Residential Support Services submitted by and paid to Homelife and authorizations for billed Day Habilitation services existed were properly documented. Issued November 30, 2017.

The audit evaluated whether state funds were used as intended for facility maintenance and payments to foster parents and whether Children’s Hope met contract requirements for supervising children, performing inventories, and documenting services. Issued November 30, 2017.

The audit evaluated whether Wee-Care complied with Texas Medicaid requirements for speech therapy claims billing, prior authorizations, speech therapy duration and total number of visits, and credentialing of speech language pathologist assistants and interns. Issued November 20, 2017.

This report describes and discusses the functions and components of PBMs in delivering pharmacy services, responsibilities for related performance and oversight, and how the functions and components interact with each other to deliver pharmacy services. Issued November 17, 2017.

The audit evaluated HALO-Flight fee-for-service claims for air ambulance services were billed in accordance with state laws, regulations, and the Texas Medicaid Provider Procedures Manual.  Results indicated no exceptions for the claims tested.  Issued November 15, 2017.

The audit objective was to evaluate activities designed to analyze eligibility determination errors for benefit programs managed by the Texas Health and Human Services (HHS) System. Issued November 13, 2017.

The audit objective was to determine whether the amounts in the capitalization and moveable equipment cost centers reported on the Providence Memorial Hospital cost report were accurate, allowable, and adequately supported according to CMS and state requirements. Issued October 31, 2017.

The audit objective was to determine whether therapy services at Sunny Springs were provided consistent with physician orders and in accordance with resident assessments and evaluations. Issued October 25, 2017.

The audit evaluated Maxor National Pharmacy Service LLC to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued August 31, 2017.

The audit objective was to determine whether the amounts in the capitalization and moveable equipment cost centers reported on the Lake Pointe Medicare cost report were accurate, allowable, and adequately supported according to CMS and state requirements. Issued August 31, 2017.

The audit evaluated HEB Pharmacy #084 to determine whether it properly billed VDP and complied with certain requirements.  Issued August 31, 2017.

The audit evaluated US Bioservices to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable.  Results indicated no exceptions for the claims tested.

The audit was conducted to determine whether confidential HHS System information in the custody of FirstCare and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 22, 2017.

This informational report summarizes acute care utilization management practices in managed care organizations based on the results of four audits performed by the HHSC IG Audit Division. Issued August 15, 2017.

The objectives of the audit were to evaluate whether MedCare complied with certain Texas Medicaid requirements. Issued August 11, 2017.

The audit evaluated Houston Medicine Chest, LLC to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued August 3, 2017.

The IG Audit Division has completed this informational report, Dental Service Organizations, to gain an understanding of DSOs and how they support the delivery of dental services provided to Medicaid and CHIP-eligible individuals. Issued May 31, 2017. Revised November 14, 2017.

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