Reports

Executive Summary

The inspection objective was to determine whether Molina Healthcare has processes and controls to ensure ambulance claim payments comply with select requirements. Issued June 1, 2023. OIG Report No. INS-23-009.

Executive Summary

The audit objective was to determine whether Sherry Matthews Group delivered and billed for selected services in compliance with applicable contract requirements. Issued March 31, 2023. OIG Report No. AUD-23-006.

The IG Quarterly Report for the second quarter of fiscal year 2023.

Executive Summary

The audit objective was to determine whether Blue Cross and Blue Shield of Texas conducted oversight activities to ensure its durable medical equipment claims were reimbursed in accordance with selected applicable contractual requirements, federal and state laws, rules, guidelines, and policies. Issued March 23, 2023. OIG Report No. AUD-23-005.

Executive Summary

This audit was to determine whether Boysville had processes and controls in place to ensure it provided foster care services at Thompson Emergency Shelter in accordance with selected statutes, contract terms, and minimum standards. Issued February 28, 2023. OIG Report No. AUD-23-004.

The IG Quarterly Report for the first quarter of fiscal year 2023.

The Joint Annual Report on Fraud and Abuse in Medicaid, compiled by OIG and the Attorney General's Medicaid Fraud Control Unit, for fiscal year 2022.

The Annual Report of State Hospital Investigations for fiscal year 2022.

The Annual Report of State Supported Living Center Investigations for fiscal year 2022

Final audit reports are posted to the OIG website when issued. These reports are subject to appeal upon timely, written, proper requests for appeal, as provided for in rule. These final audit reports are public records and remain posted on the website during and after an appeal.

Executive Summary

This report summarizes audits published between 2018 and 2022 of special investigative unit activities at five managed care organizations: Aetna Better Health of Texas, Blue Cross and Blue Shield of Texas, Community First Health Plans, Driscoll Health Plan, and Molina Healthcare of Texas. Issued November 28, 2022. OIG Report No. AUD-23-003.       

Executive Summary

The audit objective was to determine whether the Texas Health and Human Services Commission (HHSC) Home and Community-Based Services (HCS) program’s (a) residential reviews aligned with certification requirements and enforcement remedies, (b) residential reviewers used the HHSC Waiver Survey and Certification Residential Checklist correctly and consistently, and (c) residential review results were maintained and analyzed. Issued November 22, 2022. OIG Report No. AUD-23-002.

The annual report on certain fraud and abuse recoveries for fiscal year 2022.

Executive Summary

The inspection objective was to determine whether Paradigm at Woodwind Lakes followed select state and federal requirements for emergency preparedness. Issued October 12, 2022. OIG Report No. INS-23-008.

Executive Summary  

The inspection objective was to determine whether the direct care licensed nursing hours recorded at Liberty Health Care Center supported the hours submitted to the U.S. Centers for Medicare and Medicaid Services in compliance with federal requirements. Issued October 10, 2022. OIG Report No. INS-23-007.