Audit of Gaddy Enterprises: A Durable Medical Equipment Provider
The audit evaluated whether fee-for-service claims for incontinence supplies paid with Medicaid funds were billed in accordance with state laws, regulations, and program requirements.  Test results indicated no exceptions. Issued December 20, 2017.

Audit of Children’s Hope Residential Services, Inc.: Residential Child-Care Contracts with The Texas Department of Family and Protective Services
The audit evaluated whether state funds were used as intended for facility maintenance and payments to foster parents and whether Children’s Hope met contract requirements for supervising children, performing inventories, and documenting services. Issued November 30, 2017.

Homelife and Community Services, Inc.: A Texas Home and Community-Based Services Program Provider
This audit evaluated whether claims for Residential Support Services submitted by and paid to Homelife and authorizations for billed Day Habilitation services existed were properly documented. Issued November 30, 2017.

Audit of Wee-Care Pediatric Specialty Therapeutic: A Medicaid Speech Therapy Provider
The audit evaluated whether Wee-Care complied with Texas Medicaid requirements for speech therapy claims billing, prior authorizations, speech therapy duration and total number of visits, and credentialing of speech language pathologist assistants and interns. Issued November 20, 2017.

Pharmacy Benefit Managers in Texas: Informational Report on the Role of PBMs in Delivering Medicaid and CHIP Pharmacy Benefits to Managed Care Members
This report describes the functions and components of PBMs in delivering pharmacy services, responsibilities for related performance and oversight, and how the components interact with each other to delivery pharmacy services. Issued November 17, 2017; revised September 30, 2019.

Audit of HALO-Flight: A Texas Air Ambulance Provider
The audit evaluated HALO-Flight fee-for-service claims for air ambulance services were billed in accordance with state laws, regulations, and the Texas Medicaid Provider Procedures Manual.  Results indicated no exceptions for the claims tested.  Issued November 15, 2017.

HHSC Processes for Analyzing and Preventing Eligibility Determination Errors
The audit objective was to evaluate activities designed to analyze eligibility determination errors for benefit programs managed by the Texas Health and Human Services (HHS) System. Issued November 13, 2017.

Audit of Providence Memorial Hospital Cost Report: Fiscal Year 2014
The audit objective was to determine whether the amounts in the capitalization and moveable equipment cost centers reported on the Providence Memorial Hospital cost report were accurate, allowable, and adequately supported according to CMS and state requirements. Issued October 31, 2017.

Assessment and Evaluation Practices at Sunny Springs Nursing and Rehabilitation
The audit objective was to determine whether therapy services at Sunny Springs were provided consistent with physician orders and in accordance with resident assessments and evaluations. Issued October 25, 2017.

Audit of Baylor Scott & White Medical Center – Lake Pointe Cost Report: Fiscal Year 2014
The audit objective was to determine whether the amounts in the capitalization and moveable equipment cost centers reported on the Lake Pointe Medicare cost report were accurate, allowable, and adequately supported according to CMS and state requirements. Issued August 31, 2017.

Audit of Maxor National Pharmacy Service LLC: A Texas Vendor Drug Program Provider
The audit evaluated Maxor National Pharmacy Service 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 August 31, 2017.

Audit of HEB Pharmacy No. 084: A Texas Vendor Drug Program Provider
The audit evaluated HEB Pharmacy No. 084 to determine whether it properly billed VDP and complied with certain requirements.  Issued August 31, 2017.

Audit of US Bioservices Corporation: A Texas Vendor Drug Program Provider
The audit evaluated US Bioservices 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.  Results indicated no exceptions for the claims tested.  Issued August 29, 2017.

Audit of Security Controls Over Confidential HHS Information System: FirstCare Health Plans
The audit was conducted to determine whether confidential HHS System information in the custody of FirstCare and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 22, 2017.

Summary of Results from Audits of Acute Care Utilization Management in Managed Care Organizations: Informational Report
This informational report summarizes acute care utilization management practices in managed care organizations based on the results of four audits performed by the HHSC IG Audit Division. Issued August 15, 2017.