Reports
October 2018
The objectives of this audit were to determine whether claims were authorized, documented, and billed in accordance with the provider agreement, state rules, and guidelines Results indicated no exceptions for the records or claims tested. Issued October 15, 2018.
Category: AuditThe IG Quarterly Report for the fourth quarter of fiscal year 2018.
Category: QuarterlyThe annual PARIS-VA Match Report for fiscal year 2018.
Category: OtherThe Consolidated Senate Bill 30 Annual Report for fiscal year 2018.
Category: Other
September 2018
The audit evaluated Blue Cross and Blue Shield’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste, and abuse. Issued September 28, 2018.
Category: AuditThis report details the inspection to determine if Texas Medicaid processes identify or prevent duplicate capitation payments to managed care organizations for clients enrolled in both Medicaid and the Children’s Health Insurance Program. Issued September 4, 2018.
Category: Inspections
August 2018
This report details the inspection to determine whether HHSC Customer Care Center responses to OIG match action alerts prevent Supplemental Nutrition Assistance Program and Medicaid overpayments. Issued August 21, 2018.
Category: InspectionsThis report details the inspection to determine if Community Attendant Services are billed to Medicaid and rendered to clients in accordance with program requirements. Issued August 7, 2018.
Category: InspectionsThe audit was conducted to determine whether confidential HHS System information in the custody of Community First and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 2, 2018.
Category: Audit
July 2018
The audit evaluated Amber 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 July 31, 2018.
Category: AuditThe audit evaluated Premier Care Pharmacy Services 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 July 31, 2018.
Category: AuditThe audit evaluated whether Himmel complied with Texas Medicaid requirements for speech therapy authorizations, discontinuation, and claims billing; licensure, certification, and supervision of speech therapists; and medical necessity of speech therapy treatments. Issued July 23, 2018.
Category: AuditThis report details OIG's review of previously published reports, audits, and investigations of Texas HHS procurements published between 2013-2018.
Category: OtherThe OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued July 10, 2018.
Category: AuditThe OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued July 10, 2018.
Category: Audit