October 2017

Inspections

Speech Therapy
This report details the inspection of Texas Medicaid providers to examine MCO controls for prior authorization, best practices to strengthen controls, medical necessity for authorization, and speech therapy utilization rates across managed care service areas. Issued October 2, 2017.

September 2017

Issue Briefs

Issue Brief: Recovery of Funds
This issue brief provides an overview of new state and federal guidelines for Medicaid managed care organizations about the recovery of improper payments and how other states distribute recovered Medicaid funds.

August 2017

Audit

Audit of US Bioservices Corporation: A Texas Vendor Drug Program Provider
The audit evaluated US Bioservices to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable.  Results indicated no exceptions for the claims tested.  Issued August 29, 2017.

July 2017

Inspections

Pediatric Dental Sedation
This report details the inspection of Texas Medicaid providers to determine if dental sedation procedures performed on Medicaid pediatric patients are medically necessary and meet the standard of care. Issued July 14, 2017.

June 2017