Reports

Quarterly Report: Quarter 3, FY 2020
The OIG Quarterly Report for the third quarter of fiscal year 2020.

Infinity Pharmacy Solutions: A Texas Vendor Drug Program Provider
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.

Medicaid Claims for Bradley Frank
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.

Audit of Medicaid and CHIP MCO Special Investigative Units: Molina Healthcare of Texas
The audit evaluated Molina’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste and abuse. Issued May 22, 2020.

Tarrytown Expocare, LLC: A Texas Vendor Drug Program Provider
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.

Security Controls Over Confidential HHS System Information: El Paso Health
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.

Quarterly Report: Quarter 2, FY 2020
The OIG Quarterly Report for the second quarter of fiscal year 2020.

Medicaid STAR+PLUS Nursing Facility Risk Groups: Reporting Errors Affected Risk Group Assignments
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.

OIG Review of MCO Cost Avoidance and OIG Efforts in Medicaid Managed Care
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.

Collin County MHMR Center: A Local Intellectual and Developmental Disability Authority Performance Contract
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.

STAR+PLUS Waiver Program Assessments and Services Delivered: Amerigroup Insurance Company
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.

Easter Seals Rio Grande Valley: A Texas DFPS Contractor
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.

Audit of City Drug Company: A Texas Vendor Drug Program Provider
The audit evaluated City Drug Company 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 February 20, 2020.

Audit of DentaQuest USA Insurance Company: A Texas Medicaid and CHIP Dental Maintenance Organization
The audit objective was to evaluate the DentaQuest’s effectiveness in complying with selected contract requirements, achieving related contract outcomes, and reporting financial and performance results to HHSC. Issued January 9, 2020.

Security Controls Over Confidential HHS System Information: Children’s Medical Center Health Plan
The audit assessed the design and effectiveness of selected security controls over confidential HHS System information stored and processed by Children’s Medical Center Health Plan. Issued December 20, 2019.