OIG audits substance use disorder treatment provider

The OIG conducted an audit of Cenikor Foundation, a substance use disorder treatment provider under contract with the Health and Human Services Commission (HHSC). The OIG initiated the audit in response to a referral from HHSC Regulatory Services.

The OIG evaluated one contract between HHSC and Cenikor for services provided at facilities in Region 7, which includes Austin, Killeen, San Marcos, Temple and Waco. HHSC paid Cenikor $3,495,797 for services to 1,405 clients under the contract during the audit scope, from September 1, 2018 through February 29, 2020.

The audit objective was to evaluate whether Cenikor’s treatment services (a) were provided in accordance with requirements, (b) were provided by qualified staff and (c) supported the payment received. The audit found Cenikor did not consistently comply with core contractual requirements for providing adult substance use disorder program services in Region 7. Specifically, Cenikor did not:

• Ensure clients admitted into residential detoxification, intensive residential, supportive residential, and ambulatory detoxification received required monitoring for withdrawal management or counseling services. Cenikor did not provide evidence that it delivered all required monitoring or counseling services to the following clients tested:
• • 99 percent of clients admitted into its residential detoxification service.
  • 70 percent of clients admitted into its intensive residential service.
  • 47 percent of clients admitted into its supportive residential service.
  • 100 percent of clients admitted into its ambulatory detoxification service.

The audit determined Cenikor should return $124,509.66 to the State of Texas for amounts paid to Cenikor for admissions where delivery of, or support for, 50 percent or more of required monitoring or counseling services was not provided.

• Provide evidence to support performance of, and compliance with, program and contractual provisions related to medical and clinical requirements, obtaining required client consent, and referral and discharge follow-up procedures.

In addition, Cenikor did not (a) consistently place clients in service types supported by the client’s assessment and consent form or (b) ensure all direct care and clinical staff met TAC and contractual requirements related to qualifications, training and education, and supervision. This may result in placing clients in a costlier care setting than appropriate or providing services that do not meet clients’ needs.

OIG Audit offered recommendations to Cenikor, which, if implemented, will correct deficiencies in compliance with TAC and contractual requirements. Additional details are available in the full audit report.