Managed Care Claims Submitted by Respiratory & Medical Homecare Unlimited
The inspection objective was to determine whether Respiratory & Medical Homecare Unlimited supported its wound care supply claims according to guidelines. Issued October 31, 2023. OIG Report No. INS-24-003
October 2023
Managed Care Claims Submitted by Medical Plus Supplies
The inspection objective was to determine whether Medical Plus Supplies supported its wound care supply claims according to guidelines. Issued October 10, 2023. OIG Report No. INS-24-002
Managed Care Claims Submitted by Byram Healthcare Centers
Executive SummaryThe inspection objective was to determine whether Byram supported its wound care supply claims according to guidelines. Issued October 6, 2023. OIG Report No. INS-24-001
August 2023
Ambulance Claims Oversight: Community First Health Plans
Executive Summary
The inspection objective was to determine whether Community First Health Plans has processes and controls to ensure non-medically necessary ambulance claims are denied in compliance with applicable requirements. Issued August 31, 2023. OIG Report No. INS-23-012.
Ambulance Claims Oversight: Driscoll Health Plan
Executive Summary
The inspection objective was to determine whether Driscoll has processes and controls to ensure non-medically necessary ambulance claims are denied in compliance with applicable requirements. Issued August 29, 2023. OIG Report No. INS-23-011.
June 2023
Mental Health Private Psychiatric Bed Funds: PermiaCare
Executive Summary
The inspection was to determine whether PermiaCare used mental health private psychiatric bed funds in accordance with certain elements of the statement of work in its HHSC contract. Issued June 16, 2023. OIG Report No. INS-23-010
Category: Inspections
Ambulance Claims Oversight: Molina Healthcare of Texas, Inc
Executive Summary
The inspection objective was to determine whether Molina Healthcare has processes and controls to ensure ambulance claim payments comply with select requirements. Issued June 1, 2023. OIG Report No. INS-23-009.
October 2022
Nursing Facility Emergency Preparedness: Paradigm at Woodwind Lakes
Executive Summary
The inspection objective was to determine whether Paradigm at Woodwind Lakes followed select state and federal requirements for emergency preparedness. Issued October 12, 2022. OIG Report No. INS-23-008.
Nursing Facility Emergency Preparedness: Southeast Nursing & Rehabilitation Center
Executive Summary
The inspection objective was to determine whether Southeast Nursing & Rehabilitation Center followed select state and federal requirements for emergency preparedness. Issued October 10, 2022. OIG Report No. INS-23-005.
Nursing Facility Staffing Hours Verification: Liberty Health Care Center
Executive Summary
The inspection objective was to determine whether the direct care licensed nursing hours recorded at Liberty Health Care Center supported the hours submitted to the U.S. Centers for Medicare and Medicaid Services in compliance with federal requirements. Issued October 10, 2022. OIG Report No. INS-23-007.
Nursing Facility Emergency Preparedness: Arden Place of Houston
Executive Summary
The inspection objective was to determine whether Arden Place of Houston followed select state and federal requirements for emergency preparedness. Issued October 10, 2022. OIG Report No. INS-23-006.
Nursing Facility Emergency Preparedness: Alamo Heights Health and Rehabilitation Center
Executive Summary
The inspection objective was to determine whether Alamo Heights Health and Rehabilitation Center followed select state and federal requirements for emergency preparedness. Issued October 4, 2022. OIG Report No. INS-23-004.
Nursing Facility Emergency Preparedness: Focused Care at Westwood
Executive Summary
The inspection objective was to determine whether Focused Care at Westwood followed select state and federal requirements for emergency preparedness. Issued October 4, 2022. OIG Report No. INS-23-003.
September 2022
Nursing Facility Emergency Preparedness: Oak Park Nursing & Rehabilitation Center
The inspection objective was to determine whether Oak Park Nursing & Rehabilitation Center followed select state and federal requirements for emergency preparedness. The inspection did not result in any recommendations to Oak Park Nursing & Rehabilitation Center. Issued September 28, 2022. OIG Report No. INS-23-001.
Nursing Facility Emergency Preparedness: Villa Toscana at Cypress Woods
The inspection objective was to determine whether Villa Toscana at Cypress Woods followed select state and federal requirements for emergency preparedness. The inspection did not result in any recommendations to Villa Toscana at Cypress Woods. Issued September 28, 2022. OIG Report No. INS-23-002.