Employee background check and training issues found during OIG inspection
A recent inspection by the OIG found that a North Texas nursing facility did not consistently comply with requirements for newly hired staff members.
Medicaid clients and providers are a critical link in combating Medicaid fraud
Fraud Awareness Week reminds us that protecting program integrity in Medicaid requires everyone’s assistance. Clients, providers, insurers and government agencies must all work together to protect the state’s health
Pharmacy Benefit Manager uses prohibited payment and reimbursement processes
The OIG released a recent audit that showed a pharmacy benefit manager had inappropriately combined multiple components paid t
Follow-up assessment of a previously audited provider finds issues remain
A recent follow-up audit on a central Texas substance use disorder treatment service found the provider had not fully addressed three of four previously noted issues.
Audit shows lab did not receive prior approval for exceeding tested allergen limits
An OIG audit found improper billing for allergy tests, which exceeded the 30-allergen limit. The lab failed to get prior authorization for the additional allergen testing, which resulted in incorrect billing and rei
Reflecting on Inspector General Winter’s first year at the OIG
Inspector General Raymond Charles Winter discusses his first year as Inspector General, the evolving priorities of the OIG and the team's impact on safeguarding the integrity of Texas Health and Human Services.
OIG updates audit and inspections plan for fiscal year 2025
The OIG released potential audit and inspection topics for fiscal year 2025 following a risk assessment that identified programs, services, providers and contractors with an elevated potential for fraud
OIG releases results for fiscal year 2024
The OIG issued its final quarterly report for fiscal year 2024, highlighting the agency's performance, including the recovery of more than $442.3 million since September 1, 2023.
Long-term care facility leaves some discharge paperwork incomplete
A recent audit by the OIG found that a long-term care facility failed to properly inform clients of their rights and appeals channels before discharging them.
Details matter when billing Medicaid
Proper record-keeping can prevent costly errors for providers, saving resources for both the state and pharmacists.