Reports

July 2019

  • This audit evaluated whether Amerigroup complied with contractual requirements for performing service coordination in support of STAR+PLUS Level 1 members. Issued July 15, 2019.

    Category: Audit
  • This audit evaluated whether DFPS child-specific contract payments were made to psychiatric hospitals only for services not covered by STAR Health. Issued July 15, 2019.

    Category: Audit
  • The audit evaluated Best Med 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 3, 2019.

    Category: Audit

June 2019

May 2019

April 2019

  • The audit evaluated Pharmacy Alternatives 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 April 25, 2019.

    Category: Audit

March 2019

February 2019

  • This report details the inspection to determine the program integrity activities pharmacy benefit managers use to detect fraud, waste, and abuse of Medicaid-funded prescriptions. Issued February 27, 2019.

    Category: Inspections
  • This report details the inspection to determine if documentation requirements are being met when Medicaid clients receive power wheelchairs from durable medical equipment suppliers. Issued February 27, 2019.

    Category: Inspections