The Visiting Nurse Association of Texas: A Texas Home-Delivered Meals Program Provider
The audit objective was to determine if the Visiting Nurse Association of Texas provided and billed for services in compliance with selected requirements. Issued November 16, 2021.

El Paso City-County Nutrition Program: A Texas Home-Delivered Meals Program Provider
The audit objective was to determine if the El Paso City-County Nutrition Program provided and billed for services in compliance with selected requirements. Issued October 28, 2021. OIG Report No. AUD-22-004.

Health and Safety of Medicaid Beneficiaries in HHSC Home and Community Based Services Program EduCare Community Living Corporation Texas
The audit objective was to evaluate whether EduCare Community Living Corporation – Texas provided Medicaid beneficiaries living in three- and four-person residences with safe and healthy living environments, as defined by the HHSC Waiver Survey and Certification Residential Checklist and the COVID-19 emergency rules for the Home and Community-Based Services program. Issued October 15, 2021.

Managed Care Claims Submitted by Cook Children’s Home Health and Paid by Cook Children’s Health Plan: A Texas Medicaid Durable Medical Equipment and Supplies Provider
The audit objective was to determine whether documentation to support the authorization and delivery of durable medical equipment (DME) and supplies associated with Medicaid claims submitted by and paid to Cook Children’s Home Health by Cook Children’s Health Plan existed and was completed in accordance with applicable state laws, rules, and guidelines. Issued September 30, 2021.

Cenikor Foundation: Region 6 Substance Use Disorder Treatment Provider
OIG evaluated whether Cenikor’s Region 6 residential withdrawal management and intensive residential treatment services (a) were provided in accordance with selected regulations and contractual requirements and (b) supported the payment received. Issued September 29, 2021.

Audit of Vida Clinic
The OIG Audit Division contracted Myers and Stauffer LC to audit 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 31, 2021.

Cenikor Foundation: Region 11 Substance Use Disorder Treatment Provider
OIG evaluated whether Cenikor’s Region 11 residential withdrawal management and intensive residential treatment services (a) were provided in accordance with selected regulations and contractual requirements and (b) supported the payment received. Issued August 26, 2021.

Avita Pharmacy
The OIG Audit Division contracted Myers and Stauffer LC to audit whether pharmacy 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 26, 2021.

Co-Treatment Therapy Billing: Rebound Sports and Physical Therapy
The audit objective was to determine if Rebound performed co-treatment services, which occur when two or more therapy disciplines are performed concurrently, were billed correctly. Issued August 26, 2021.

Health and Safety of Medicaid Beneficiaries in the HHSC Home and Community-Based Services Program: Community Options, Inc.
The audit objective was to evaluate whether Community Options, Inc. provided Medicaid beneficiaries living in three- and four-person residences with safe and healthy living environments, as defined by the HHSC Waiver Survey and Certification Residential Checklist and the COVID-19 emergency rules for the Home and Community-Based Services program. Issued August 26, 2021.

Angleton Health Mart Pharmacy
The OIG Audit Division contracted Myers and Stauffer LC to audit whether pharmacy 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 25, 2021.

Health and Safety of Medicaid Beneficiaries in the HHSC Home and Community-Based Services Program: Kenmar Residential HCS Services, Inc.
The audit objective was to evaluate whether Kenmar Residential HCS Services, Inc. provided Medicaid beneficiaries living in three- and four-person residences with safe and healthy living environments, as defined by the HHSC Waiver Survey and Certification Residential Checklist and the COVID-19 emergency rules for the Home and Community-Based Services program. Issued August 23, 2021.

NorthgateArinso, Inc: A Texas Health and Human Services Commission Contractor
The audit objectives were to determine whether (a) the Retrospective Cost Settlement statements for the unaudited periods of the original contract, as amended, with HHSC, contract years 2019 and 2020, were reasonably stated and (b) NorthgateArinso, Inc. was in compliance with a selected renewal contract requirement for information security. Issued August 20, 2021.

Aetna Better Health of Texas: Special Investigative Unit
The audit evaluated Aetna’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste and abuse. Issued August 18, 2021.

Cenikor Foundation: Region 4 Substance Use Disorder Treatment Provider
OIG evaluated whether Cenikor’s Region 4 residential withdrawal management and intensive residential treatment services (a) were provided in accordance with selected regulations and contractual requirements and (b) supported the payment received. Issued August 13, 2021.