Reports

This limited-scope audit explored the prevalence of DME services being provided after a Medicaid beneficiary’s death. For the deliveries tested, verification systems showed the beneficiary as eligible at the time of delivery. Therefore, this audit did not result in recommendations to All Star. Issued August 14, 2020.

The audit evaluated whether there was valid support for the authorization and delivery of fee-for-service durable medical equipment and supplies associated with Medicaid claims submitted by and paid to Aveanna as required by state laws, rules, and guidelines. Issued July 30, 2020.

This audit determined whether contract controls ensured AACOG coordinated services to enrollees, monitored service delivery and reported general revenue expenses according to contract requirements, and documented paid encounters. Issued July 29, 2020.

The IG Quarterly Report for the third quarter of fiscal year 2020.

The audit evaluated Infinity Pharmacy Solutions, LLC to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued June 23, 2020.

The OIG Audit and Inspections Division contracted Myers and Stauffer, LC to audit behavioral health records to verify services provided to recipients, paid by Texas Medicaid. Issued June 15, 2020.

The audit evaluated Molina’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste and abuse. Issued May 22, 2020.

The audit evaluated Tarrytown Expocare, LLC to determine whether it properly billed VDP and complied with contractual and state requirements, and evaluated IT general controls to determine whether data used for audit testing was reliable. Issued May 11, 2020.

The audit assessed the design and effectiveness of selected security controls over confidential HHS System information stored and processed by El Paso Health. Issued April 24, 2020.

The IG Quarterly Report for the second quarter of fiscal year 2020.

The audit focused on members with a discrepancy between utilization and nursing facility risk group categorization for at least 12 months during the audit scope and concluded that HHSC overpaid $1.38 million to MCOs for Medicaid recipients not eligible for managed care. Published March 30, 2020.

This report was submitted to the Legislative Budget Board and the Governor in compliance with the 2020-21 General Appropriations Act, House Bill 1, 86th Legislature, Regular Session, 2019 (Article II, Health and Human Services Commission, Rider 114). Issued February 28, 2020.

This audit tested whether Collin County MHMR Center coordinated services to enrollees, monitored and evaluated service delivery, and reported general revenue expenses according to contract requirements. Issued February 28, 2020. Revised March 6, 2020.

This audit determined whether Amerigroup properly assessed members to participate in the Home and Community Based Services (HBCS) Waiver in the Medicaid Rural Service Area (MRSA) West. Issued February 28, 2020.

The audit was to determine whether controls over contract funds were in place and data was reported to DFPS in accordance with contract terms. No issues were noted. Issued February 26, 2020.