December 2021

Other

Joint OIG-MFCU Report
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 2021.

November 2021

October 2021

Audit

Health and Safety of Medicaid Beneficiaries in HHSC Home and Community Based Services Program EduCare Community Living Corporation Texas
The audit objective was to evaluate whether EduCare Community Living Corporation – Texas provided Medicaid beneficiaries living in three- and four-person residences with safe and healthy living environments, as defined by the HHSC Waiver Survey and Certification Residential Checklist and the COVID-19 emergency rules for the Home and Community-Based Services program. Issued October 15, 2021.

September 2021

Audit

Managed Care Claims Submitted by Cook Children’s Home Health and Paid by Cook Children’s Health Plan: A Texas Medicaid Durable Medical Equipment and Supplies Provider
The audit objective was to determine whether documentation to support the authorization and delivery of durable medical equipment (DME) and supplies associated with Medicaid claims submitted by and paid to Cook Children’s Home Health by Cook Children’s Health Plan existed and was completed in accordance with applicable state laws, rules, and guidelines. Issued September 30, 2021.

Audit

Cenikor Foundation: Region 6 Substance Use Disorder Treatment Provider
OIG evaluated whether Cenikor’s Region 6 residential withdrawal management and intensive residential treatment services (a) were provided in accordance with selected regulations and contractual requirements and (b) supported the payment received. Issued September 29, 2021.

Other

Rolling Audit and Inspections Plan
The OIG has updated its Rolling Audit and Inspections Plan, which outlines potential audit and inspections areas and topics.

The OIG Audit and Inspections Division conducts a continuous risk assessment to identify potential topics for inclusion in its Rolling Audit and Inspections Plan. Potential audit and inspections topics consist of programs, services, providers and contractors with an elevated potential for fraud, waste and abuse.