August 2023

Audit

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.

Audit

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.

Audit

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.

Audit

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.

Audit

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.

Audit

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.

Audit

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.

Audit

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.

July 2023

Audit

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.