Reports

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.

United Way of Metropolitan Dallas: A DFPS Contractor
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.

Data Integrity of Online Provider Directories: Inspection on Accuracy of Provider Information
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.

Audit of Medicine Man: A Texas Vendor Drug Program Provider
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.

Audit of STAR+PLUS Service Coordination: Cigna HealthSpring
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.

LogistiCare: A Texas Medicaid Medical Transportation Organization
The audit was conducted to determine whether LogistiCare’s performance in selected areas was in accordance with contract requirements. Issued August 22, 2019.

Fraud and Abuse Prevention: Dental Services
This article explains how to prevent being the target of fraud or abuse by dental solicitors. Issued August 1, 2019.

Audit of Security Controls Over Confidential HHS System Information and Business Continuity and Disaster Recovery Plans: Texas Children’s Health Plan
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.

Project Amistad: A Texas Medicaid Medical Transportation Organization
The audit was conducted to determine whether Amistad’s performance in selected areas was in accordance with contract requirements. Issued July 23, 2019.

Audit of Texas Medicaid and CHIP Pharmacy Benefit Services Delivered by Molina and Its PBM, Caremark
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.

Medical Transportation Management, Inc.: A Texas Medicaid Medical Transportation Organization
The audit was conducted to determine whether MTM’s performance in selected areas was in accordance with contract requirements. Issued July 17, 2019.

Audit of STAR+PLUS Service Coordination: Amerigroup Texas
This audit evaluated whether Amerigroup complied with contractual requirements for performing service coordination in support of STAR+PLUS Level 1 members. Issued July 15, 2019.

Audit of DFPS Child-Specific Contracts
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.

Audit of Best Med: A Texas Vendor Drug Program Provider
The audit evaluated Best Med 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 July 3, 2019.

Quarterly Report: Quarter 3, FY 2019
The OIG Quarterly Report for the third quarter of fiscal year 2019.