Mental Health Targeted Case Management and Mental Health Rehabilitative Services in Managed Care: Local Mental Health Authorities and Local Behavioral Health Authorities in Texas Medicaid
The inspection focused on mental health targeted case management and mental health rehabilitative services provided by local mental health authorities (LMHAs) and local behavioral health authority (LBHA) contracted providers. Issued August 30, 2021.

Supplemental Nutrition Assistance Program: Second Level Review Process
This inspection determined the second level review process is operating effectively to detect errors and prevent distribution of ineligible SNAP benefits. As a result, no observations were identified for this inspection. Issued August 25, 2021.

The National Correct Coding Initiative in Texas Medicaid: Informational Report on Use of NCCI Edits by Managed Care Organizations
The objective was to understand whether MCOs have processes in place for deployment of current NCCI edits and how often those edits are updated. Issued August 12, 2021.

Documentation of Reductions to Authorized Levels of Care: Local Mental Health Authorities in Texas
This inspection assessed whether the reduction of Medicaid members' mental health services by LMHAs was documented and in compliance with Texas Administrative Code and Texas Resilience and Recovery Utilization Management Guidelines: Adult Mental Health Services. Issued July 28, 2021.

Inspection of Telemonitoring Services: Prior Authorizations
OIG completed an inspection to determine whether fee-for-service telemonitoring provider services were consistent with selected state requirements. No exceptions to requirements were observed. Issued: April 29, 2021.

Processes for Hiring Direct Support Professionals at State Supported Living Centers: Texas Health and Human Services Commission Human Resources
This inspection assessed whether HHSC-HR performed preemployment due diligence checks for direct support professionals hired to work at SSLCs consistent with (a) Texas Administrative Code requirements and (b) HHSC-HR policies and procedures. Issued February 25, 2021.

Child and Adolescent Needs and Strengths (CANS 2.0) Assessment: CANS 2.0 Assessments in Community-Based Care
This inspection assessed whether ACH Child and Family Services conducted CANS 2.0 assessments for children entering community-based care and provided services to those children timely. Published December 18, 2020

Processes for Hiring and Training Direct Support Professionals: Austin State Supported Living Center
The inspection assessed whether Austin State Supported Living Center, with the assistance of Texas Health and Human Services Commission Human Resources, hires and trains direct support professionals in accordance with Texas Administrative Code requirements. Issued November 9, 2020.

Unclaimed Funds: Inspection of the Process to Recover HHSC Funds from the Texas Comptroller’s Unclaimed Property Program
Ths report details the inspection to determine if Texas Medicaid Healthcare Partnership - Third Party Liability has effective processes to recover HHSC identifiable funds from the Texas Comptroller of Public Accounts, Unclaimed Property Program. Issued November 20, 2019.

Member Complaints Received by Texas Medicaid Managed Care Organizations: Series II
 This report details the inspection to determine if Managed Care Organizations' complaint intake and resolution processes are consistent with the Uniform Managed Care Manual and Uniform Managed Care Contract requirements. Issued October 4, 2019.

Eligibility Determinations for Out-of-State Clients: Inspection of Actions Performed by Access and Eligibility Services
This report details the inspection to determine if Texas Medicaid ensures only eligible out-of-state Texas residents receive benefits. Issued August 30, 2019.

Data Integrity of Online Provider Directories: Inspection on Accuracy of Provider Information
This report details the inspection to determine the accuracy of data contained in the online provider directories of managed care organizations. Issued August 23, 2019.

Member Complaints Received by Texas Managed Care Organizations: Series I
This report details the inspection to determine if managed care organization member complaint intake processes are consistent with the Uniform Managed Care Contract and Uniform Managed Care Manual requirements. Issued March 7, 2019.

Durable Medical Equipment: Power Wheelchairs
This report details the inspection to determine if documentation requirements are being met when Medicaid clients receive power wheelchairs from durable medical equipment suppliers. Issued February 27, 2019.

Pharmacy Benefit Managers: Inspection of Program Integrity Activities
This report details the inspection to determine the program integrity activities pharmacy benefit managers use to detect fraud, waste, and abuse of Medicaid-funded prescriptions. Issued February 27, 2019.