September 2022

Inspections

Nursing Facility Emergency Preparedness: Villa Toscana at Cypress Woods
The inspection objective was to determine whether Villa Toscana at Cypress Woods followed select state and federal requirements for emergency preparedness. The inspection did not result in any recommendations to Villa Toscana at Cypress Woods. Issued September 28, 2022. OIG Report No. INS-23-002.

Inspections

Nursing Facility Emergency Preparedness: Oak Park Nursing & Rehabilitation Center
The inspection objective was to determine whether Oak Park Nursing & Rehabilitation Center followed select state and federal requirements for emergency preparedness. The inspection did not result in any recommendations to Oak Park Nursing & Rehabilitation Center. Issued September 28, 2022. OIG Report No. INS-23-001.

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.

Audit

Maximus, Inc., Member Communications: Texas Medicaid and CHIP Enrollment Broker
Executive Summary

The audit objective was to determine whether Maximus accurately, timely, and in accordance with applicable requirements (a) communicated enrollment-related information to members who were determined eligible for Medicaid and CHIP services and (b) received and processed enrollment-related information from those members in state fiscal year 2021. Issued September 2, 2022. OIG Report No. AUD-23-001.

August 2022

Audit

Sunwest Behavioral Associates PA
The OIG Audit and Inspections Division contracted Weaver and Tidwell, L.L.P. to audit whether services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 31, 2022.

Audit

Heart of Texas Region MHMR Center n/k/a Heart of Texas Behavioral Health Network
The OIG Audit and Inspections Division contracted Weaver and Tidwell, L.L.P. to audit whether services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 31, 2022.

 

Audit

One Source Medical Group
The OIG Audit and Inspections Division contracted DK Partners to audit whether delivery of Durable Medical Equipment and submissions of Medicaid and CHIP managed care claims by One Source were in accordance with applicable Federal and State Medicaid laws, regulations, rules, policies, and contractual requirements.  Issued August 31, 2022.

Audit

Aeroflow Inc.
The OIG Audit and Inspections Division contracted DK Partners to audit whether delivery of Durable Medical Equipment and submissions of Medicaid and CHIP managed care claims by Aeroflow were in accordance with applicable Federal and State Medicaid laws, regulations, rules, policies, and contractual requirements.  Issued August 30, 2022.

Audit

Y Medical Associates, Inc.
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to audit whether pharmacy claims billed and paid under the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 29, 2022.

Audit

Southside Pharmacy 9
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to audit whether pharmacy claims billed and paid under the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 29, 2022.

Audit

Texas Home Modification Services
The OIG Audit and Inspections Division contracted DK Partners to determine whether delivery of Durable Medical Equipment and submissions of Medicaid and CHIP managed care claims by Texas Home Modification Services were in accordance with applicable Federal and State Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 26, 2022.

Audit

Inpatient Psychiatric Hospitals: Cypress Creek Hospital
Executive SummaryThe audit objective was to determine whether Cypress Creek completed admission, commitment, and specific consent requirements for STAR+PLUS members receiving inpatient psychiatric services in accordance with selected federal and state regulations, rules, and policies. Issued August 25, 2022. OIG Report No. AUD-22-025.

Audit

Inpatient Psychiatric Hospitals: West Oaks Hospital
Executive Summary - The audit objective was to determine whether West Oaks completed admission, commitment, and specific consent requirements for STAR+PLUS members receiving inpatient psychiatric services in accordance with selected federal and state regulations, rules, and policies. Issued August 26, 2022. OIG Report No. AUD-22-026.