Baylor Scott & White Health: A Texas Medicaid Provider
Executive SummaryThe audit objective was to determine whether (a) teleservices provided by Baylor Scott & White Health were billed accurately and in accordance with applicable requirements and (b) related internal controls over teleservices were designed and operating effectively. Issued November 29, 2023. OIG Report No. AUD-24-002.

About OIG Audit reports
Final audit reports are posted to the OIG website when issued. These reports are subject to appeal upon timely, written, proper requests for appeal, as provided for in rule. These final audit reports are public records and remain posted on the website during and after an appeal.

Managed Care Pharmacy Encounters Paid to Bemaj Pharmacy, Inc.: A Managed Care Network Provider Contracted Under Amerigroup Texas, Inc., Amerigroup Insurance Company, and Superior HealthPlan, Inc.
Executive Summary

The audit objective was to determine whether Bemaj Pharmacy, Inc. (a) properly billed for selected paid encounters associated with Texas Medicaid members enrolled with Amerigroup and Superior and (b) complied with applicable contractual, state, and federal requirements. Issued September 1, 2023. OIG Report No. AUD-24-001.

Rolling Audit and Inspections Plan 2024
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.

The Bridge Over Troubled Waters, Inc.
Executive Summary

The OIG conducted an audit to determine whether The Bridge Over Troubled Waters, a Family Violence Program contractor, had financial processes and controls in place to ensure grant expenditures were accurate, allowable, and supported. Issued August 30, 2023. OIG Report No. AUD-23-035

Roberto Canales M.D.P.A.
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether telemedicine 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, 2023. OIG Report No. AUD-23-036.

Edinburg Pediatric Network
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether telemedicine 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 29, 2023. OIG Report No. AUD-23-034.

Driscoll Children’s Health Plan Special Investigative Unit
Executive Summary

The OIG evaluated whether Driscoll complied with selected state and contractual requirements related to (a) preventing, detecting, and investigating fraud, waste and abuse and (b) reporting reliable information on SIU activities, results and recoveries to the OIG. Issued August 23, 2023. OIG Report No. AUD-23-032.

Little Spurs Pediatric Urgent Care
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether telemedicine 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 24, 2023. OIG Report No. AUD-23-033.

Aapex Pharmacy
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 23, 2023. OIG Report No. AUD-23-031.

Lauve’s Pediatric Extended Care: A Prescribed Pediatric Extended Care Center in Longview, Texas
Executive Summary

The audit objective was to determine whether Lauve’s Pediatric Extended Care (Lauve's Pediatric) provided services in accordance with selected rules, statutes, and requirements. Issued August 22, 2023. OIG Report No. AUD-23-029.

Oversight of the Sexually Transmitted Disease/Human Immunodeficiency Virus (STD/HIV) Prevention Services Program: Texas Department of State Health Services
Executive Summary

The audit objective was to determine whether the Texas Department of State Health Services (DSHS), through certain contracting and program management functions, effectively managed the STD/HIV Prevention Services Program. Issued August 22, 2023. OIG Report No. AUD-23-030.

Follow-Up Assessment on Previously Issued Audit Recommendations: Fee-for-Service Claims Submitted by Aveanna Healthcare Medical Solutions
This follow-up assessment of the previously issued audit report titled “Fee for Service Claims Submitted by Aveanna Healthcare Medical Solutions: A Texas Medicaid Durable Medical Equipment and Supplies Provider” to determine the implementation status of audit recommendations previously issued by OIG Audit. Issued August 21, 2023. OIG Report No. AUD-23-027.

Cook Children’s Physician Network
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine 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 21, 2023. OIG Report No. AUD-23-028.

The PsyClinic: A Texas Medicaid Provider
Executive Summary

The audit objective was to determine whether (a) teleservices provided by the PsyClinic were billed accurately and in accordance with applicable requirements and (b) related internal controls over teleservices were designed and operating effectively. Issued August 18, 2023. OIG Report No. AUD-23-026.