Reports

Executive Summary

OIG evaluated whether Le Rêve, advertising as a memory care facility, provided services delivered and operated in compliance with applicable laws, rules, and guidelines. Issued May 10, 2022. OIG Report No. AUD-22-011.

Executive Summary

The audit objective was to determine whether telemedicine services provided by Medcare Clinics PLLC during the COVID-19 waiver period (a) were billed accurately and (b) followed applicable requirements. Issued April 29, 2022. OIG Report No. AUD-22-010.

Executive Summary

OIG evaluated whether Mission Road operated and provided residential DBMD services at its assisted living facilities in compliance with applicable contractual requirements, laws, rules, and guidelines. Issued April 28, 2022. OIG Report No. AUD-22-009.

Executive Summary

OIG evaluated whether Community First complied with selected state and contractual requirements related to (a) preventing, detecting, and investigating fraud, waste, and abuse and (b) reporting reliable information on SIU activities, results, and recoveries to the Texas Health and Human Services Commission (HHSC). Issued April 28, 2022. OIG Report No. AUD-22-008.

Executive Summary

The audit objective was to determine whether telemedicine services provided by the Center for Comprehensive Mental Health during the COVID-19 waiver period (a) were billed accurately and (b) followed applicable requirements. Issued April 19, 2022. OIG Report No. AUD-22-007.

Executive Summary

OIG evaluated whether Village Green -- Cypress, which advertises as a memory care facility, provided services delivered and operated in compliance with applicable laws, rules, and guidelines. Audit issued February 28, 2022. OIG Report No. AUD-22-006.

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.

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.

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.

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.

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.

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.

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.

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.

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.