October 2018

September 2018

Inspections

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

July 2018

Audit

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.

Audit

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.

June 2018