The audit evaluated whether paid Medicaid claims for air ambulance services and their associated ground transports were billed in accordance with state rules and guidelines, and contractual requirements. Issued February 26, 2019

The objective of the audit was to determine the reliability of UnitedHealthcare sub-capitated encounter data and claims-based encounter data.  Issued February 26, 2019.

The OIG presentation on technology projects given to the House Appropriations Subcommittee on Article II on February 19, 2019.

This article explains how to prevent being the target of fraud or abuse in your home. Issued February 15, 2019.

The OIG presentation given to the House Appropriations Subcommittee on Article II on February 12, 2019.

The OIG presentation given to the Senate Finance Committee on February 5, 2019.

The audit evaluated Metscript Pharmacy No. 2 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 11, 2019.

Issue Brief: Encounter Data

January 2019 Issue Briefs

This Issue Brief outlines how the OIG uses encounter data (a record of paid cliams by MCOs and DMOs) to monitor and detect fraud, waste, and abuse. Issued January 17, 2019.

This report details the inspection to determine if home health providers obtain and evaluate background information on attendant care personnel to ensure client safety. Issued January 16, 2019.

This report details the inspection to determine if HHSC Access and Eligibility Services properly addresses non-verified Social Security numbers to prevent ineligible client enrollment in Texas Medicaid. Issued January 3, 2019.

Quarterly Report: Quarter 1, FY 2019

December 2018 Quarterly

The IG Quarterly Report for the first quarter of fiscal year 2019.

This audit evaluated whether fee-for-service claims submitted by and paid to Bethesda Lutheran were authorized, documented, and billed in accordance with the HCS provider agreement and with state rules and guidelines. Issued December 14, 2018.

The audit evaluated Avita Drugs 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 November 30, 2018.

The audit evaluated Passage of Youth to determine whether it (a) used state funds as intended for foster children, (b) conducted oversight of foster parents, and (c) implemented and updated children’s service plans. Issued November 30, 2018.

The audit was conducted to determine whether confidential HHS System information in the custody of Amerigroup and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued November 30, 2018.

This audit evaluated whether claims for residential support services and supervised living submitted by and paid to Lakes Regional and authorizations for other HCS services existed were properly documented. Issued November 30, 2018.

This audit evaluated whether claims for residential support services and supervised living submitted by and paid to Mission Road and authorizations for other HCS services existed were properly documented. Issued November 30, 2018.

The audit evaluated Cystic Fibrosis Services, Inc. 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 November 26, 2018.

Joint OIG-MFCU Report

November 2018 Other

The Joint Annual Report on Fraud and Abuse in Medicaid, compiled by OIG and the Attorney General's Medicaid Fraud Control Unit, for fiscal year 2018.

MCO Fraud Recoveries Report

November 2018 Other

The Annual Report on Certain Fraud and Abuse recoveries for fiscal year 2018.

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