Quarterly Report: Quarter 2, FY 2023
The OIG Quarterly Report for the second quarter of fiscal year 2023.

Managed Care Organization Oversight of Durable Medical Equipment Providers: Blue Cross and Blue Shield of Texas
Executive Summary

The audit objective was to determine whether Blue Cross and Blue Shield of Texas conducted oversight activities to ensure its durable medical equipment claims were reimbursed in accordance with selected applicable contractual requirements, federal and state laws, rules, guidelines, and policies. Issued March 23, 2023. OIG Report No. AUD-23-005.

Thompson Emergency Shelter, Operated by Boysville
Executive Summary

This audit was to determine whether Boysville had processes and controls in place to ensure it provided foster care services at Thompson Emergency Shelter in accordance with selected statutes, contract terms, and minimum standards. Issued February 28, 2023. OIG Report No. AUD-23-004.

Quarterly Report: Quarter 1, FY 2023
The OIG Quarterly Report for the first quarter of fiscal year 2023.

Joint OIG-MFCU Report Fiscal Year 2022
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 2022.

State Supported Living Center Investigations Report FY 2022
The Annual Report of State Supported Living Center Investigations for fiscal year 2022

State Hospital Investigations Report FY 2022
The Annual Report of State Hospital Investigations for fiscal year 2022.

Summary of Results: Audits of Medicaid and CHIP MCO Special Investigative Units
Executive Summary

This report summarizes audits published between 2018 and 2022 of special investigative unit activities at five managed care organizations: Aetna Better Health of Texas, Blue Cross and Blue Shield of Texas, Community First Health Plans, Driscoll Health Plan, and Molina Healthcare of Texas. Issued November 28, 2022. OIG Report No. AUD-23-003.       

Oversight of the HHSC Home and Community-Based Services (HCS) Program: HHS Regulatory Services Division and HHS Contract Administration and Provider Monitoring
Executive Summary

The audit objective was to determine whether the Texas Health and Human Services Commission (HHSC) Home and Community-Based Services (HCS) program’s (a) residential reviews aligned with certification requirements and enforcement remedies, (b) residential reviewers used the HHSC Waiver Survey and Certification Residential Checklist correctly and consistently, and (c) residential review results were maintained and analyzed. Issued November 22, 2022. OIG Report No. AUD-23-002.

MCO Fraud Recoveries Report
The annual report on certain fraud and abuse recoveries for fiscal year 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 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: 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 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.