Audit finds Medicaid enrollment broker met most requirements but still found areas of concern
A recent audit on the state's Medicaid enrollment broker found that most requirements related to communicating and processing enrollment information were met; however, some processes had room for improvement.
Lock-In program helps fight prescription drug abuse
The Texas health care community plays a critical role in preventing prescription misuse through the Medicaid Lock-In Program (MLIP), administered by the OIG.
OIG inspects skilled nursing facilities reported staff hours
OIG inspectors recently reviewed records from a skilled nursing facility to determine if the hours of direct care provided by licensed nursing staff were accurately reported.
Upholding patient care, preventing fraud in nursing homes
The goal of the OIG’s work in nursing facilities is to support patient care and ensure the proper expenditure of Medicaid dollars.
MCO audit finds more than $1.5 million in overstated expenses
An OIG audit of a managed care organization (MCO) found issues related to the documentation and inclusion of certain expenses in their combined financial statistical report (FSR).
Behavioral health hospital audited by OIG
Recently, OIG team members audited a 128-bed behavioral health center in Houston, Texas, to determine if the facility met specific requirements established by state and federal regulations.
$6.2 million in benefit overpayments recovered during first quarter of fiscal year
The OIG’s Benefits Program Integrity (BPI) unit completed 3,205 investigations involving some form of benefit recipient overpayment or fraud allegation in the first quarter of fiscal year 2023.
OIG reports $103 million in first quarter recoveries
The Office of Inspector General published its first quarterly report for fiscal year 2023, with performance metrics, case summaries and agency highlights.
OIG conducts emergency preparedness inspections
As winter weather begins to move into Texas, this is an excellent time for long-term care facilities to review and update emergency response plans for the health and safety of residents.
OIG develops automated fraud data analytics model
The OIG continues to enhance fraud detection using a Department of Agriculture grant to build data-driven methods of identifying beneficiary fraud in the Supplemental Nutrition Assistance Program (SNAP).