Security Controls Over Confidential HHS Information: Aetna Better Health of Texas
The audit assessed the design and effectiveness of selected security controls over confidential HHS System information stored and processed by Aetna Better Health of Texas. Issued August 24, 2020.

Final Audit Report: Elgin Pharmacy
The OIG Audit Division contracted Myers and Stauffer, LC to audit pharmacy claims to verify services provided to recipients, paid by Texas Medicaid. Issued August 21, 2020.

Final Audit Report: Ennis Pharmacy
The OIG Audit Division contracted Myers and Stauffer, LC to audit pharmacy claims to verify services provided to recipients, paid by Texas Medicaid. Issued August 21, 2020.

Durable Medical Equipment Delivered to Deceased Beneficiaries: Nextra Health
This limited-scope audit explored the prevalence of DME services being provided after a Medicaid beneficiary’s death. For the deliveries tested, verification systems showed the beneficiary as eligible at the time of delivery. Therefore, this audit did not result in recommendations to Nextra. Issued August 20, 2020.

Durable Medical Equipment Delivered to Deceased Beneficiaries: All Star Medical Equipment and Supply
This limited-scope audit explored the prevalence of DME services being provided after a Medicaid beneficiary’s death. For the deliveries tested, verification systems showed the beneficiary as eligible at the time of delivery. Therefore, this audit did not result in recommendations to All Star. Issued August 14, 2020.

Fee-for-Service Claims Submitted by Aveanna Healthcare Medical Solutions: A Texas Medicaid Durable Medical Equipment and Supplies Provider
The audit evaluated whether there was valid support for the authorization and delivery of fee-for-service durable medical equipment and supplies associated with Medicaid claims submitted by and paid to Aveanna as required by state laws, rules, and guidelines. Issued July 30, 2020.

Alamo Area Council of Governments: Local Developmental and Disability Authority Performance and Medicaid Contracts
This audit determined whether contract controls ensured AACOG coordinated services to enrollees, monitored service delivery and reported general revenue expenses according to contract requirements, and documented paid encounters. Issued July 29, 2020.

Infinity Pharmacy Solutions: A Texas Vendor Drug Program Provider
The audit evaluated Infinity Pharmacy Solutions, LLC to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued June 23, 2020.

Medicaid Claims for Bradley Frank
The OIG Audit and Inspections Division contracted Myers and Stauffer, LC to audit behavioral health records to verify services provided to recipients, paid by Texas Medicaid. Issued June 15, 2020.

Audit of Medicaid and CHIP MCO Special Investigative Units: Molina Healthcare of Texas
The audit evaluated Molina’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste and abuse. Issued May 22, 2020.

Tarrytown Expocare, LLC: A Texas Vendor Drug Program Provider
The audit evaluated Tarrytown Expocare, LLC to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued May 11, 2020.

Security Controls Over Confidential HHS System Information: El Paso Health
The audit assessed the design and effectiveness of selected security controls over confidential HHS System information stored and processed by El Paso Health. Issued April 24, 2020.

Medicaid STAR+PLUS Nursing Facility Risk Groups: Reporting Errors Affected Risk Group Assignments
The audit focused on members with a discrepancy between utilization and nursing facility risk group categorization for at least 12 months during the audit scope and concluded that HHSC overpaid $1.38 million to MCOs for Medicaid recipients not eligible for managed care. Published March 30, 2020.

Collin County MHMR Center: A Local Intellectual and Developmental Disability Authority Performance Contract
This audit tested whether Collin County MHMR Center coordinated services to enrollees, monitored and evaluated service delivery, and reported general revenue expenses according to contract requirements. Issued February 28, 2020. Revised March 6, 2020.

STAR+PLUS Waiver Program Assessments and Services Delivered: Amerigroup Insurance Company
This audit determined whether Amerigroup properly assessed members to participate in the Home and Community Based Services (HBCS) Waiver in the Medicaid Rural Service Area (MRSA) West. Issued February 28, 2020.