Reports
August 2023
The audit objective was to determine whether Lauve’s Pediatric Extended Care (Lauve's Pediatric) provided services in accordance with selected rules, statutes, and requirements. Issued August 22, 2023. OIG Report No. AUD-23-029.
Category: AuditThis follow-up assessment of the previously issued audit report titled “Fee for Service Claims Submitted by Aveanna Healthcare Medical Solutions: A Texas Medicaid Durable Medical Equipment and Supplies Provider” to determine the implementation status of audit recommendations previously issued by OIG Audit. Issued August 21, 2023. OIG Report No. AUD-23-027.
Category: AuditThe OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 21, 2023. OIG Report No. AUD-23-028.
Category: AuditThe audit objective was to determine whether (a) teleservices provided by the PsyClinic were billed accurately and in accordance with applicable requirements and (b) related internal controls over teleservices were designed and operating effectively. Issued August 18, 2023. OIG Report No. AUD-23-026.
Category: AuditThis informational report provides (a) an overview of how Texas Medicaid and CHIP patients can access DME and supplies, (b) Texas Medicaid and CHIP requirements for DME and supplies providers, (c) research and analysis of DME and supplies, and (d) a discussion of the different types of DME and supplies. Issued August 15, 2023. OIG Report No. AUD-23-025.
Category: AuditThe audit objective was to determine whether Driscoll Health Plan had select information security controls that effectively protected confidential Texas Health and Human Services (HHS) System information. Issued August 15, 2023. OIG Report No. AUD-23-024.
Category: AuditThe OIG evaluated whether Parkland 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 OIG. Issued August 11, 2023. OIG Report No. AUD-23-023.
Category: AuditThe OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine 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 August 8, 2023. OIG Report No. AUD-23-022.
Category: AuditThe audit objective was to determine whether (a) Texas Children’s Health Plan, Inc. reported expenses on selected components of its 334-day 2021 Medical and Combined financial statistical reports submitted to the Texas Health and Human Services Commission in accordance with contract requirements and laws and (b) the related internal controls over the preparation of the financial statistical reports were designed and operating effectively. Issued August 7, 2023. OIG Report No. AUD-23-018.
Category: AuditThe objective of the follow-up assessment was to determine the implementation status of OIG Audit’s previously issued recommendation to Parkland Community Health Plan, Inc., which included testing the effectiveness of management activities designed to remediate the identified recommendation. Issued August 7, 2023. OIG Report No. AUD-23-019.
Category: AuditThe OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether fee-for-service durable medical equipment and medical supply claims billed to, and paid under, the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 8, 2023. OIG Report No. AUD-23-021.
Category: AuditThe audit objective was to determine whether Texas Children’s Hospital-Specialty Pharmacy (a) properly billed for selected paid encounters associated with Texas Medicaid members enrolled with UnitedHealthcare and (b) complied with applicable contractual, state, and federal requirements. Issued August 8, 2023. OIG Report No. AUD-23-020.
Category: AuditThe OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine 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 August 4, 2023. OIG Report No. AUD-23-016.
Category: AuditThe OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether fee-for-service durable medical equipment and medical supply claims billed to, and paid under, the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 4, 2023. OIG Report No. AUD-23-014.
Category: AuditThe objective of the follow-up assessment was to determine the implementation status of OIG Audit’s previously issued recommendation to Aetna Better Health of Texas, which included testing the effectiveness of management activities designed to remediate the identified recommendation. Issued August 4, 2023. OIG Report No. AUD-23-017.
Category: Audit