Reports

This report details the inspection to determine if Texas Medicaid ensures only eligible out-of-state Texas residents receive benefits. Issued August 30, 2019.

The audit determined whether services were authorized and provided to STAR Kids members in MDCP who received private duty nursing, and service coordination activities, assessments, and service plans supported the services for MDCP members who received private duty nursing. Issued August 30, 2019.

The audit objective was to evaluate the MCNA’s effectiveness in complying with selected contract requirements, achieving related contract outcomes, and reporting financial and performance results to HHSC. Issued August 30, 2019.

The audit determined whether Medicaid and CHIP Services, through monitoring selected contract deliverables, effectively managed the STAR Kids and STAR Health programs for the Medically Dependent Children Program (MDCP). Issued August 30, 2019.

The audit was to determine whether contract funds were used as intended and the contractor billed and performed as required. No issues were noted. Issued August 28, 2019.

This report details the inspection to determine the accuracy of data contained in the online provider directories of managed care organizations. Issued August 23, 2019.

The audit was conducted to determine whether LogistiCare’s performance in selected areas was in accordance with contract requirements. Issued August 22, 2019.

The audit evaluated Medicine Man 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 August 22, 2019.

This audit evaluated whether Cigna complied with contractual requirements for performing service coordination in support of STAR+PLUS Level 1 members. Issued August 22, 2019.

This article explains how to prevent being the target of fraud or abuse by dental solicitors. Issued August 1, 2019.

The audit was conducted to determine whether confidential HHS System information in the custody of Texas Children’s Health Plan and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued July 31, 2019.

The audit was conducted to determine whether Amistad’s performance in selected areas was in accordance with contract requirements. Issued July 23, 2019.

The audit determined whether delivery of selected pharmacy benefits by Molina and its subcontracted PBM, Caremark, was effective and in compliance with criteria in the Uniform Managed Care Contract, the Uniform Managed Care Manual, and applicable state rules and statutes. Issued July 19, 2019.

The audit was conducted to determine whether MTM’s performance in selected areas was in accordance with contract requirements. Issued July 17, 2019.

This audit evaluated whether DFPS child-specific contract payments were made to psychiatric hospitals only for services not covered by STAR Health. Issued July 15, 2019.