2020 Reports

Value-based purchasing (VBP) models are utilized in government health insurance programs to shift payments from volume to value. This informational report explores how VBP has evolved nationally, Texas’ implementation and a discussion of potential program integrity challenges and considerations related to the OIG’s future work in this space. Issued December 21, 2020. Summary version.

The IG Quarterly Report for the first quarter of fiscal year 2021.

This inspection assessed whether ACH Child and Family Services conducted CANS 2.0 assessments for children entering community-based care and provided services to those children timely. Published December 18, 2020

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 2020.

OIG conducted this audit as a follow-up to complaints of nursing facility payments being delayed by more than 90 days and of unprocessed retroactive adjustments. The audit objective was to determine whether Molina accurately and timely adjudicated qualified nursing facility provider clean claims in compliance with selected criteria. Issued December 9, 2020.

The Annual Report on Certain Fraud and Abuse recoveries for fiscal year 2020.

The audit evaluated whether there was valid support for the authorization and delivery of fee-for-service durable medical equipment and supplies associated with Medicaid claims submitted by and paid to Maverick Medical Supply as required by state laws, rules, and guidelines. Issued November 30, 2020.

OIG conducted this audit as a follow-up to complaints of nursing facility payments being delayed by more than 90 days and of unprocessed retroactive adjustments. The audit objective was to determine whether Superior HealthPlan accurately and timely adjudicated qualified nursing facility provider clean claims in compliance with selected criteria. Issued November 20, 2020.

Homeward Bound ensured that clients met requirements to be eligible for its substance use disorder programs, including verifying that clients met financial requirements but should strengthen controls related to its HIV and residential detox programs. Issued November 13, 2020.

The Annual Report of State Supported Living Center Investigations for fiscal year 2020.

The Annual Report of State Hospital Investigations for fiscal year 2020.

The inspection assessed whether Austin State Supported Living Center, with the assistance of Texas Health and Human Services Commission Human Resources, hires and trains direct support professionals in accordance with Texas Administrative Code requirements. Issued November 9, 2020.

The IG Quarterly Report for the fourth quarter of fiscal year 2020.

The annual PARIS-VA Match Report for fiscal year 2020.

The Consolidated Senate Bill 30 Annual Report for fiscal year 2020.