Community First Health Plan Special Investigative Unit: A Texas Medicaid Managed Care Provider
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.
April 2022
The Center for Comprehensive Mental Health: A Texas Medicaid Provider
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.
March 2022
Quarterly Report: Quarter 2, FY 2022
The OIG Quarterly Report for the second quarter of fiscal year 2022.
February 2022
Selected Memory Care Facilities: Village Green Alzheimer’s Care Home -- Cypress
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.
OIG Review of MCO Cost Avoidance and OIG Efforts in Medicaid Managed Care
This report was submitted to the Legislative Budget Board and the Governor in compliance with the 2022-23 General Appropriations Act, Senate Bill 1, 87th Legislature, Regular Session, 2021 (Article II, Health and Human Services Commission, Rider 104). Issued February 25th, 2022.
Nursing Facility Staffing Hours Verification: The Villa at Mountain View
The inspection objective was to determine whether the licensed nursing hours recorded at the Villa at Mountain View supported the hours submitted to the U.S. Centers for Medicare and Medicaid Services (CMS) in compliance with federal requirements. The inspection did not result in any recommendations to the Villa at Mountain View. Issued February 17, 2022. OIG Report No. INS-22-001.
December 2021
Quarterly Report: Quarter 1, FY 2022
The OIG Quarterly Report for the first quarter of fiscal year 2022.
Joint OIG-MFCU Report
The Joint Annual Report on Fraud and Abuse in Medicaid, compiled by OIG and the Attorney General's Medicaid Fraud Control Unit, for fiscal year 2021.
November 2021
MCO Fraud Recoveries Report
The Annual Report on Certain Fraud and Abuse recoveries for fiscal year 2021.
The Visiting Nurse Association of Texas: A Texas Home-Delivered Meals Program Provider
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.
State Hospital Investigations Report FY 2021
The Annual Report of State Hospital Investigations for fiscal year 2021.
SSLC Investigations Report FY 2021
The Annual Report of State Supported Living Center Investigations for fiscal year 2021
October 2021
El Paso City-County Nutrition Program: A Texas Home-Delivered Meals Program Provider
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.
Health and Safety of Medicaid Beneficiaries in HHSC Home and Community Based Services Program EduCare Community Living Corporation Texas
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.