Reports

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.

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.
 

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.

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.

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.

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.

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.

The IG Quarterly Report for the third quarter of fiscal year 2022.

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.

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.

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.

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.

Executive Summary

OIG evaluated whether Mission Road operated and provided residential DBMD services at its assisted living facilities in compliance with applicable contractual requirements, laws, rules, and guidelines. Issued April 28, 2022. OIG Report No. AUD-22-009.

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.

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.