Audit of Cook Children’s Teddy Bear Transport: A Texas Medicaid Air Ambulance Provider
The audit evaluated whether paid Medicaid claims for air ambulance services and their associated ground transports were billed in accordance with state rules and guidelines, and contractual requirements. Issued February 26, 2019
February 2019
Audit of Epic Pediatric Therapy: A Texas Medicaid Speech Therapy Provider
The audit evaluated Epic to determine whether it properly billed the MCO FirstCare Health Plans for Medicaid claims and complied with contractual and state requirements. Issued February 26, 2019.
Audit of Metscript Pharmacy No. 2: A Texas Vendor Drug Program Provider
The audit evaluated Metscript Pharmacy No. 2 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 February 11, 2019.
December 2018
Bethesda Lutheran Homes and Services: A Texas Medicaid Home and Community-Based Services Program Provider
This audit evaluated whether fee-for-service claims submitted by and paid to Bethesda Lutheran were authorized, documented, and billed in accordance with the HCS provider agreement and with state rules and guidelines. Issued December 14, 2018.
November 2018
Audit of Mission Road Developmental Center: A Texas Medicaid Home and Community-Based Services Program Provider
This audit evaluated whether claims for residential support services and supervised living submitted by and paid to Mission Road and authorizations for other HCS services existed were properly documented. Issued November 30, 2018.
Audit of Passage of Youth Family Center: Child-Placing Agency Residential Child-Care Contract with the Texas Department of Family and Protective Services
The audit evaluated Passage of Youth to determine whether it (a) used state funds as intended for foster children, (b) conducted oversight of foster parents, and (c) implemented and updated children’s service plans. Issued November 30, 2018.
Audit of Lakes Regional MHMR Center: A Texas Medicaid Home and Community-Based Services Program Provider
This audit evaluated whether claims for residential support services and supervised living submitted by and paid to Lakes Regional and authorizations for other HCS services existed were properly documented. Issued November 30, 2018.
Audit of Avita Drugs: A Texas Vendor Drug Program Provider
The audit evaluated Avita Drugs 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 November 30, 2018.
Audit of Security Controls Over Confidential HHS System Information: Amerigroup Texas, Inc.
The audit was conducted to determine whether confidential HHS System information in the custody of Amerigroup and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued November 30, 2018.
Audit of Cystic Fibrosis Services, Inc.: A Texas Vendor Drug Program Provider
The audit evaluated Cystic Fibrosis Services, Inc. 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 November 26, 2018.
October 2018
Audit of Coastal Plains Community Center: A Medicaid HCS Provider
The objectives of this audit were to determine whether claims were authorized, documented, and billed in accordance with the provider agreement, state rules, and guidelines Results indicated no exceptions for the records or claims tested. Issued October 15, 2018.
September 2018
Audit of Medicaid and CHIP MCO SIUs: Blue Cross and Blue Shield of Texas
The audit evaluated Blue Cross and Blue Shield’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste, and abuse. Issued September 28, 2018.
August 2018
Audit of Security Controls Over Confidential HHS System Information: Community First Health Plans
The audit was conducted to determine whether confidential HHS System information in the custody of Community First and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 2, 2018.
July 2018
Audit of Premier Care Pharmacy Services: A Texas Vendor Drug Program Provider
The audit evaluated Premier Care Pharmacy Services 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 July 31, 2018.
Audit of Amber Pharmacy: A Texas Vendor Drug Program Provider
The audit evaluated Amber Pharmacy 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 July 31, 2018.