El Dorado Texas Community Service Center: A Substance Use Medication Assisted Treatment Provider
Executive Summary - HHSC-contracted substance use disorder medication assisted treatment facilities provide services to Texas residents who meet financial and clinical eligibility requirements. The audit objective was to determine whether El Dorado provided services in accordance with applicable requirements and accurately billed for services provided. Issued May 12, 2025. Report Executive Summary No. AUD-25-015
May 2025
Informational Report: Community Centers with Local Mental Health Authority and Local Behavioral Health Authority Designations in Texas
Executive Summary - This informational report provides information about LMHA and LBHA coverage in Texas, services provided, delivery methods, state and federal funding from HHSC, service delivery processes, and requirements. Issued March 14, 2025 and revised April 23, 2025. OIG Report No. AUD-25-010.
April 2025
Immunotherapy Services in Texas Medicaid: Imran Baig, M.D.
Executive Summary - The audit objective was to determine whether claims submitted for immunotherapy services complied with applicable requirements. Issued April, 17, 2025. Report No. AUD-25-014.
West Texas Centers: A Local Mental Health Authority Contracted with the Texas Health and Human Services Commission
Executive Summary - The audit objective was to determine whether West Texas Centers complied with selected state and contractual requirements. Issued April 17, 2025. OIG Report No. AUD-25-013.
Nursing Facility Transfers to Emergency Rooms: Seven Acres Jewish Senior Care Services, Inc.
Executive Summary - The inspection objective was to determine whether Seven Acres initiated resident transfers to emergency rooms in accordance with applicable requirements. Issued April 11, 2025. OIG Report No. INS-25-009.
AllOne Health Resources, Inc.: An Employee Assistance Program Services Provider Contracted with the Texas Department of Family and Protective Services
Executive Summary - The audit objective was to determine whether AllOne Health Resources, Inc. complied with selected Texas Department of Family and Protective Services employee assistance program contractual requirements. Issued April 9, 2025. OIG Report No. AUD-25-012.
March 2025
Quarterly Report: Quarter 2, FY 2025
The OIG published its second quarterly report for fiscal year 2025, summarizing the agency’s work and results achieved between December 1, 2024, and February 28, 2025.
Centers for Independent Living: San Antonio Independent Living Services
Executive Summary - San Antonio Independent Living Services (SAILS), a center for independent living (CIL), generally complied with requirements when providing purchased services, which include goods and services purchased to assist people in meeting their independent living goals. Issued March 26, 2025. Report No. AUD-25-011.
Cypress Creek Rehabilitation and Healthcare Center: Nursing Facility Abuse, Neglect, Exploitation, and Misappropriation
Executive Summary - The inspection objective was to determine whether Cypress Creek Rehabilitation and Healthcare Center has processes and procedures to document and report abuse, neglect, exploitation, and misappropriation incidents as required by state law. Issued March 20, 2025. Report No. INS-25-008
Paradigm at Faith Memorial: Nursing Facility Abuse, Neglect, Exploitation, and Misappropriation
Executive Summary - The inspection objective was to determine whether Paradigm at Faith Memorial (Faith Memorial) has processes and procedures to document and report abuse, neglect, exploitation, and misappropriation incidents as required by state law. Issued March 18, 2025. Report No. INS-25-007
MCO Provider Claims Appeals: Community First Health Plans
The OIG conducted this inspection to determine whether Community First tracks, resolves, and reports provider claims appeals as required. Issued March 14, 2025. Report No. INS-25-006
February 2025
Wellpoint Texas Special Investigative Unit
Executive Summary - The OIG evaluated the effectiveness of Wellpoint’s special investigative unit performance in (a) preventing, detecting, and investigating fraud, waste, and abuse and (b) reporting reliable information on SIU activities, results, and recoveries to the Texas Health and Human Services (HHS) Office of Inspector General (OIG). Issued February 28, 2025. OIG Report No. AUD-25-009.
Case-by-Case Services: Texas Children’s Health Plan
Executive Summary - The OIG conducted this inspection to determine whether Texas Children’s Health Plan reported case-by-case services in accordance with applicable requirements. Issued February 27, 2025. OIG Report No. INS-25-005
Follow-Up Assessment on a Previously Published Audit Report: Managed Care Claims Submitted by Cook Children’s Home Health
The objective of this follow-up assessment was to determine the resolution status of OIG Audit’s previously identified issues at Cook Children’s Home Health, which included testing the effectiveness of management activities designed to remediate identified issues. Issued February 11, 2025. OIG Report No. AUD-25-008.
January 2025
Joint Annual Interagency Coordination Report
The Joint Annual Interagency Coordination Report summarizes the collaborative activities of the HHS Office of Inspector General and Office of Attorney General Civil Medicaid Fraud Division and Medicaid Fraud Control Unit in the detection and prevention of fraud, waste and abuse in Texas Medicaid.