ReCept Pharmacy #31
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine 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 20, 2024. OIG Report No. AUD-24-025.

Allergy Immunotherapy Services in Texas Medicaid: Calvary Medical
Executive Summary - The audit objective was to determine whether claims submitted by Calvary Medical Clinic for allergy immunotherapy services complied with selected guidelines. Issued August 16, 2024. OIG Report No. AUD-24-024

Pediatric Home Service
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether paid MCO medical supply claims billed to, 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 15, 2024. OIG Report No. AUD-24-023.

Comfort & Care Medical Supplies, Inc.
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether paid MCO DME and medical supply claims billed to, 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 15, 2024. OIG Report No. AUD-24-022.

Allergy Testing in Texas Medicaid: Quest Diagnostics Clinical Laboratories, Inc.
Executive Summary - The audit objective was to determine whether claims submitted by Quest Diagnostics for allergy blood tests complied with selected Texas Medicaid Provider Procedure Manual guidelines. Issued August 7, 2024. OIG Report No. AUD-24-019

Nueva Vida Behavioral Health Associates
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether behavioral health claims billed to, 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 8 2024. OIG Report No. AUD-24-021.

Alaniz Counseling and Behavioral Center, PC
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether behavioral health claims billed to, 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 8 2024. OIG Report No. AUD-24-020.

Managed Care Pharmacy Benefit Services- Navitus Health Solutions, LLC
Executive Summary - The audit objective was to determine whether Navitus (a) completed and reported payments and reimbursements for Texas Medicaid and CHIP managed care pharmacy benefit services accurately and in accordance with applicable requirements and (b) effectively designed and operated related internal controls over payments and reporting. Issued August 7, 2024. OIG Report No. AUD-24-018

Case-by-Case Services: Community First Health Plans
Executive Summary - The OIG conducted this inspection to determine whether Community First Health Plans reported case-by-case services in accordance with applicable requirements. Issued August 6, 2024. OIG Report No. INS-24-009

Pharmacy Alternatives, LLC
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine 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 July 31, 2024. OIG Report No. AUD-24-017.

Cook Children’s Health Plan’s Financial Statistical Reports
Executive Summary - The audit objective was to determine whether Cook Children’s Health Plan (a) reported expenses on its FSRs in accordance with contract requirements and (b) designed and implemented effective internal controls over the preparation of its FSRs. Issued July 23, 2024. OIG Report No. AUD-24-016.

Security Controls Over Confidential HHS Information: Dell Children’s Health Plan
The audit objective was to determine whether Dell Children’s Health Plan had select information security controls that effectively protected confidential Texas Health and Human Services (HHS) System information. Issued July 19, 2024. OIG Report No. AUD-24-015.

Regulation of Texas Child Day Care Centers and Homes
Executive Summary - The OIG conducted this audit to determine whether HHS processed permit renewals and reviewed child day care operations in accordance with selected rules, statutes, and requirements. Issued July 17, 2024. OIG Report No. AUD-24-014. 

Mountain View Health and Rehabilitation: Long-Term Care Facility Resident Discharges
Executive Summary - The OIG conducted this audit to determine whether Mountain View Health and Rehabilitation complied with applicable requirements when initiating discharges. Issued July 16, 2024. OIG Report No. AUD-24-013. 

Crystal City Pharmacy, LLC
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine 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 July 16, 2024. OIG Report No. AUD-24-012.