Security Controls Over Confidential HHS Information: Driscoll Health Plan
The audit objective was to determine whether Driscoll Health Plan had select information security controls that effectively protected confidential Texas Health and Human Services (HHS) System information. Issued August 15, 2023. OIG Report No. AUD-23-024.
August 2023
Informational Report: Texas Medicaid (Title XIX) Home Health Durable Medical Equipment (DME) and Supplies
Executive Summary
This informational report provides (a) an overview of how Texas Medicaid and CHIP patients can access DME and supplies, (b) Texas Medicaid and CHIP requirements for DME and supplies providers, (c) research and analysis of DME and supplies, and (d) a discussion of the different types of DME and supplies. Issued August 15, 2023. OIG Report No. AUD-23-025.
Parkland Community Health Plan Special Investigative Unit
Executive Summary
The OIG evaluated whether Parkland 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 11, 2023. OIG Report No. AUD-23-023.
Lifeline Valley Care
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether fee-for-service durable medical equipment 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 8, 2023. OIG Report No. AUD-23-021.
Managed Care Pharmacy Encounters Paid to Texas Children’s Hospital-Specialty Pharmacy
Executive Summary
The audit objective was to determine whether Texas Children’s Hospital-Specialty Pharmacy (a) properly billed for selected paid encounters associated with Texas Medicaid members enrolled with UnitedHealthcare and (b) complied with applicable contractual, state, and federal requirements. Issued August 8, 2023. OIG Report No. AUD-23-020.
Express Pharmacy #3
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 8, 2023. OIG Report No. AUD-23-022.
Administrative and Medical Expenses Reported on Financial Statistical Reports: Texas Children’s Health Plan, Inc.
Executive Summary
The audit objective was to determine whether (a) Texas Children’s Health Plan, Inc. reported expenses on selected components of its 334-day 2021 Medical and Combined financial statistical reports submitted to the Texas Health and Human Services Commission in accordance with contract requirements and laws and (b) the related internal controls over the preparation of the financial statistical reports were designed and operating effectively. Issued August 7, 2023. OIG Report No. AUD-23-018.
Follow-Up Assessment on Previously Issued Audit Recommendations: Security Controls Over Confidential HHS Information at Parkland Community Health Plan, Inc.
The objective of the follow-up assessment was to determine the implementation status of OIG Audit’s previously issued recommendation to Parkland Community Health Plan, Inc., which included testing the effectiveness of management activities designed to remediate the identified recommendation. Issued August 7, 2023. OIG Report No. AUD-23-019.
15RX Pharmacy #3
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 4, 2023. OIG Report No. AUD-23-015.
Metrocare 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 4, 2023. OIG Report No. AUD-23-016.
R Medical Outreach and Associates, LLC
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether fee-for-service durable medical equipment 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 4, 2023. OIG Report No. AUD-23-014.
Follow-Up Assessment on Previously Issued Audit Recommendations: Security Controls Over Confidential HHS Information at Aetna Better Health of Texas
The objective of the follow-up assessment was to determine the implementation status of OIG Audit’s previously issued recommendation to Aetna Better Health of Texas, which included testing the effectiveness of management activities designed to remediate the identified recommendation. Issued August 4, 2023. OIG Report No. AUD-23-017.
July 2023
Summary of Results: Security Controls Over Confidential HHS Information
This report summarizes confidential audit results assessing the design and effectiveness of selected security controls over confidential HHS System information. Issued July 27, 2023. OIG Report No. AUD-23-012.
Follow-Up Assessment on Previously Issued Audit Recommendations: Financial Statistical Reports and Information Security at DentaQuest USA Insurance Company, Inc.
The objective of the follow-up assessment was to determine the implementation status of OIG Audit’s previously issued recommendations to HHS Medicaid and CHIP Services (MCS), which included testing the effectiveness of MCS and DentaQuest USA Insurance Company, Inc. management activities designed to remediate identified recommendations. Issued July 28, 2023. OIG Report No. AUD-23-013.
Fred and Mabel R. Parks Emergency Shelter Operated by Parks Youth Ranch
Executive Summary
The OIG conducted an audit to determine whether Parks Youth Ranch had processes and controls in place to ensure it provided foster care services at Parks Emergency Shelter in accordance with selected statutes, contract terms, and minimum standards. Issued July 18, 2023. OIG Report No. AUD-23-011