Quarterly Report: Quarter 4, FY 2018
The OIG Quarterly Report for the fourth quarter of fiscal year 2018.
October 2018
Consolidated SB 30 Report
The Consolidated Senate Bill 30 Annual Report for fiscal year 2018.
PARIS-VA Match Report
The annual PARIS-VA Match Report for fiscal year 2018.
September 2018
Audit of Medicaid and CHIP MCO SIUs: Blue Cross and Blue Shield of Texas
The audit evaluated Blue Cross and Blue Shield’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste, and abuse. Issued September 28, 2018.
Duplicate Capitation Payments to Managed Care
This report details the inspection to determine if Texas Medicaid processes identify or prevent duplicate capitation payments to managed care organizations for clients enrolled in both Medicaid and the Children’s Health Insurance Program. Issued September 4, 2018.
August 2018
Access and Eligibility Services: Interstate and Income Match Action Alerts
This report details the inspection to determine whether HHSC Customer Care Center responses to OIG match action alerts prevent Supplemental Nutrition Assistance Program and Medicaid overpayments. Issued August 21, 2018.
Long-Term Services and Supports: Community Attendant Services
This report details the inspection to determine if Community Attendant Services are billed to Medicaid and rendered to clients in accordance with program requirements. Issued August 7, 2018.
Audit of Security Controls Over Confidential HHS System Information: Community First Health Plans
The audit was conducted to determine whether confidential HHS System information in the custody of Community First and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 2, 2018.
July 2018
Audit of Premier Care Pharmacy Services: A Texas Vendor Drug Program Provider
The audit evaluated Premier Care Pharmacy Services 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. Issued July 31, 2018.
Audit of Amber Pharmacy: A Texas Vendor Drug Program Provider
The audit evaluated Amber Pharmacy 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. Issued July 31, 2018.
OIG Review of the HHS Procurement Process: 2013-2018
This report details OIG's review of previously published reports, audits, and investigations of Texas HHS procurements published between 2013-2018.
Audit of Himmel Home Health: A Medicaid Speech Therapy Provider
The audit evaluated whether Himmel complied with Texas Medicaid requirements for speech therapy authorizations, discontinuation, and claims billing; licensure, certification, and supervision of speech therapists; and medical necessity of speech therapy treatments. Issued July 23, 2018.
Audit of Travis Medical Sales Corp.: A Durable Medical Equipment Provider
The OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued July 10, 2018.
Audit of URS Medical I: A Durable Medical Equipment Provider
The OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued July 10, 2018.
June 2018
Quarterly Report: Quarter 3, FY 2018
The OIG Quarterly Report for the third quarter of fiscal year 2018.