The OIG audited Le Rêve Rehabilitation and Memory Care (Le Rêve) to determine if staffing requirements were met for patient safety and review whether clients were properly notified about facility certifications.
The Texas Exclusions Database simplifies applicant screening for Medicaid providers, offering the ability to better protect their patients with real-time verification of potential employees before they are hired.
The OIG audited the Community First Health Plans, Inc. special investigative unit (SIU) and determined it did not consistently meet requirements designed to reduce fraud, waste and abuse.
The OIG continues to enhance fraud detection using funds from a U.S. Department of Agriculture (USDA) grant to build data-driven methods of identifying Supplemental Nutrition Assistance Program (SNAP) fraud.
The OIG conducted an audit of claims for psychiatric services to ensure the Center for Comprehensive Mental Health in McAllen billed correctly for telemedicine services.
The OIG Fraud Detection Operation (FDO) team identified three behavioral health service providers who submitted claims for service that were flagged by data algorithms.
The OIG Electronic Benefits Transfer (EBT) Trafficking Unit conducts investigations on allegations of the misuse or trafficking of Supplemental Nutrition Assistance Program (SNAP) benefits by retailers.
More providers are participating in the OIG self-report process so they can determine if they need to disclose overpayments received from participation in Texas Health and Human Services (HHS) programs.
The OIG continues to broaden its use of data analysis to help uncover fraud, waste and abuse (FWA) trends in the health care system by assessing potentially problematic behavior patterns.
The OIG Benefits Program Integrity (BPI) unit investigates allegations of overpayments to clients participating in the benefits programs administered by the Texas Health and Human Services Commission.