April 2018

February 2018

Audit

Audit of Southside Pharmacy: A Texas Vendor Drug Program Provider
The audit evaluated Southside 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 February 9, 2018; revised February 28, 2018.

December 2017

Audit

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.

November 2017

Audit

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.

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

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.

October 2017

Audit

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.

August 2017