Nursing Facility Staffing Hours Verification: Winchester Lodge Healthcare Center
Executive Summary

The inspection objective was to determine whether the direct care licensed nursing hours recorded at Winchester Lodge Healthcare Center supported the hours submitted to the U.S. Centers for Medicare and Medicaid Services in compliance with federal requirements. Issued August 9, 2022. OIG Report No. INS-22-007.

Healthy City Pharmacy
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to audit whether pharmacy claims billed and paid under the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued July 25, 2022.

The Sexually Transmitted Disease/Human Immunodeficiency Virus (STD/HIV) Prevention Services Grant Program: Dallas County Health and Human Services
Executive Summary

The audit objective was to determine whether Dallas County Health and Human Services had processes and controls in place to ensure it administered the STD/HIV Prevention Services Grant Program in accordance with selected grant agreement requirements for performance, data management, reporting, and grant expenditures. Issued August 2, 2022. OIG Report No. AUD-22-017.

Security Controls Over Confidential HHS Information: Community Health Choice
The audit assessed the design and effectiveness of selected security controls over confidential HHS System information stored and processed by Scott and White Health Plan. Issued July 22, 2022. OIG Report No. AUD-22-015.

Selected Memory Care Facilities: Matagorda House Healthcare Center
Executive Summary 

OIG evaluated whether Matagorda House, advertising as a memory care facility, provided services delivered and operated in compliance with applicable laws, rules, and guidelines. Issued July 22, 2022. OIG Report No. AUD-22-016.

 

The Sexually Transmitted Disease/Human Immunodeficiency Virus (STD/HIV) Prevention Services Grant Program: San Antonio Metropolitan Health District
Executive Summary

The audit objective was to determine whether the San Antonio Metropolitan Health District had processes and controls in place to ensure it administered the STD/HIV Prevention Services Grant Program in accordance with selected grant agreement requirements for performance, data management, reporting, and grant expenditures. Issued July 15, 2022. OIG Report No. AUD-22-014.

Clinical Laboratory Improvement Amendments (CLIA) Certification Series 4
Executive Summary

This inspection examined the processes Cook Children’s Health Plan, El Paso Health, and Superior HealthPlan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 12, 2022. OIG Report No. INS-22-005.

Clinical Laboratory Improvement Amendments (CLIA) Certification Series 3
Executive Summary

This inspection examined the processes Amerigroup, Blue Cross and Blue Shield of Texas, Dell Children’s Health Plan, Molina Healthcare of Texas, and United Healthcare Community Plan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 12, 2022. OIG Report No. INS-22-004.

Clinical Laboratory Improvement Amendments (CLIA) Certification Series 2
Executive Summary

This inspection examined the processes Aetna Better Health of Texas, Community First Health Plans, Driscoll Health Plan, and Parkland Community Health Plan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 11, 2022. OIG Report No. INS-22-003.

Clinical Laboratory Improvement Amendments (CLIA) Certification Series 1
Executive Summary

This inspection examined the processes Community Health Choice, FirstCare HealthPlans, Scott & White Health Plan, and Texas Children’s Health Plan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 11, 2022. OIG Report No. INS-22-002.

Quarterly Report: Quarter 3, FY 2022
The OIG Quarterly Report for the third quarter of fiscal year 2022.

Selected Memory Care Facilities: Silverado Barton Springs Memory Care Community
Executive Summary

OIG evaluated whether Silverado Barton Springs, advertising as a memory care facility, provided services delivered and operated in compliance with applicable laws, rules, and guidelines. Issued June 3, 2022. OIG Report No. AUD-22-013.

Deaf Blind with Multiple Disabilities Program: Lighthouse for the Blind of Houston
Executive Summary

OIG evaluated whether Lighthouse operated and provided residential DBMD services at its assisted living facilities in compliance with applicable contractual requirements, laws, rules, and guidelines. Issued May 19, 2022. OIG Report No. AUD-22-012.

Selected Memory Care Facilities: Le Rêve Rehabilitation and Memory Care
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.

Medcare Clinics PLLC: A Texas Medicaid and CHIP Provider
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.