The OIG Audit Division performed an inventory of selected drugs to determine whether Richard's Pharmacy correctly billed Medicaid, complied with requirements, and maintained sound controls over its related IT systems for the audit period. Issued June 27, 2018.

The OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued June 27, 2018.

The OIG Audit Division contracted Health Management Systems to audit personal care assistance records to verify services provided to recipients, paid by Texas Medicaid. Issued June 13, 2018.

The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.

The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.

The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.

This report details the inspection to determine if Texas Medicaid made multiple capitation payments for clients with multiple Medicaid ID numbers. Issued June 8, 2018.

The audit evaluated Specialty Therapeutic Care 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 May 31, 2018.

This report details the inspection of capitation payments made for deceased clients in the Texas Medicaid system, to determine how processes can be strengthened to identify and recoup those payments. Issued May 29, 2018.

This report details the inspection of the Electronic Visit Verification (EVV) System to determine how effective it is at verifying that home visits for Medicaid clients occurred and at confirming that home services were provided. Issued May 29, 2018.

The OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued May 25, 2018.

The OIG Audit Division contracted Health Management Systems to audit behavioral health records to verify services provided to recipients, paid by Texas Medicaid. Issued May 25, 2018.

The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients paid by Texas Medicaid. Issued May 25, 2018.

The audit evaluated Minimum Data Set (MDS) assessments, therapy services charts, medical records, Resource Utilization Group (RUG) levels assigned to residents, and physician orders and certifications for therapy services. Issued May 11, 2018.

This presentation was made by Inspector General Sylvia Hernandez Kauffman on the topic of program integrity in managed care.

This issue brief provides an overview of attendant care services, which provide Medicaid clients the assistance they need to stay in their community, instead of living in a long-term care (LTC) facility.

The audit evaluated Cook Children’s Home Health 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.

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. Issued April 27, 2018.

The audit evaluated Driscoll’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste, and abuse. Issued April 3, 2018.

This report was submitted to the Legislative Budget Board and the Governor in compliance with the 2018-2019 General Appropriations Act, Senate Bill 1, 85th Legislature, Regular Session, 2017 (Article II, Health and Human Services Commission, Rider 152). Issued March 29, 2018.

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