Joint OIG-MFCU Report
The Joint Annual Report on Fraud and Abuse in Medicaid, compiled by OIG and the Attorney General's Medicaid Fraud Control Unit, for fiscal year 2019.
December 2019
Summary of Results: Audits of Texas Medicaid Medical Transportation Organizations
This audit report summarizes non-emergency medical transportation services in Texas Medicaid managed transportation organizations, based on the results of four audits performed by the OIG Audit Division. Issued December 3, 2019.
November 2019
MCO Fraud Recoveries Report
The Annual Report on Certain Fraud and Abuse recoveries for fiscal year 2019. Revised April 14, 2020.
Unclaimed Funds: Inspection of the Process to Recover HHSC Funds from the Texas Comptroller’s Unclaimed Property Program
Ths report details the inspection to determine if Texas Medicaid Healthcare Partnership - Third Party Liability has effective processes to recover HHSC identifiable funds from the Texas Comptroller of Public Accounts, Unclaimed Property Program. Issued November 20, 2019.
State Hospital Investigations Report
The Annual Report of State Hospital Investigations for fiscal year 2019.
SSLC Investigations Report
The Annual Report of State Supported Living Center Investigations for fiscal year 2019.
October 2019
Member Complaints Received by Texas Medicaid Managed Care Organizations: Series II
This report details the inspection to determine if Managed Care Organizations' complaint intake and resolution processes are consistent with the Uniform Managed Care Manual and Uniform Managed Care Contract requirements. Issued October 4, 2019.
Consolidated SB 30 Report
The Consolidated Senate Bill 30 Annual Report for fiscal year 2019.
September 2019
Quarterly Report: Quarter 4, FY 2019
The OIG Quarterly Report for the fourth quarter of fiscal year 2019.
PARIS-VA Match Report
The annual PARIS-VA Match Report for fiscal year 2019.
August 2019
Audit of Selected Services to STAR Health Members in the Medically Dependent Children Program: Superior HealthPlan
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.
Eligibility Determinations for Out-of-State Clients: Inspection of Actions Performed by Access and Eligibility Services
This report details the inspection to determine if Texas Medicaid ensures only eligible out-of-state Texas residents receive benefits. Issued August 30, 2019.
Audit of Selected Services to STAR Kids Members in the Medically Dependent Children Program: Cook Children’s Health Plan
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.
Audit of MCNA Insurance Company: A Texas Medicaid and CHIP Dental Maintenance Organization
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.
Audit of Management of the STAR Kids and STAR Health Programs Through Monitoring Contract Activities: HHSC Medicaid and CHIP Services
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.