Reports

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 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 audit evaluated Epic to determine whether it properly billed the MCO FirstCare Health Plans for Medicaid claims and complied with contractual and state requirements. 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 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.

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

This Issue Brief outlines how the OIG uses encounter data (a record of paid claims 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.

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.

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 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.