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 2018.
November 2018
MCO Fraud Recoveries Report
The Annual Report on Certain Fraud and Abuse recoveries for fiscal year 2018.
State Hospital Investigations Report
The Annual Report of State Hospital Investigations for fiscal year 2018.
SSLC Investigations Report
The Annual Report of State Supported Living Center Investigations for fiscal year 2018.
October 2018
Data Review: Medicaid Lock-In Program
This data review provides an overview of the Medicaid Lock-In Program, which is used to restrict the overuse of medical services.
Presentation to House Committee on General Investigating and Ethics
The OIG presentation given to the House Committee on General Investigating and Ethics on October 25, 2018.
Audit of Coastal Plains Community Center: A Medicaid HCS Provider
The objectives of this audit were to determine whether claims were authorized, documented, and billed in accordance with the provider agreement, state rules, and guidelines Results indicated no exceptions for the records or claims tested. Issued October 15, 2018.
Quarterly Report: Quarter 4, FY 2018
The OIG Quarterly Report for the fourth quarter of fiscal year 2018.
Consolidated SB 30 Report
The Consolidated Senate Bill 30 Annual Report for fiscal year 2018.
PARIS-VA Match Report
The annual PARIS-VA Match Report for fiscal year 2018.
September 2018
Audit of Medicaid and CHIP MCO SIUs: Blue Cross and Blue Shield of Texas
The audit evaluated Blue Cross and Blue Shield’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste, and abuse. Issued September 28, 2018.
Duplicate Capitation Payments to Managed Care
This report details the inspection to determine if Texas Medicaid processes identify or prevent duplicate capitation payments to managed care organizations for clients enrolled in both Medicaid and the Children’s Health Insurance Program. Issued September 4, 2018.
August 2018
Access and Eligibility Services: Interstate and Income Match Action Alerts
This report details the inspection to determine whether HHSC Customer Care Center responses to OIG match action alerts prevent Supplemental Nutrition Assistance Program and Medicaid overpayments. Issued August 21, 2018.
Long-Term Services and Supports: Community Attendant Services
This report details the inspection to determine if Community Attendant Services are billed to Medicaid and rendered to clients in accordance with program requirements. Issued August 7, 2018.
Audit of Security Controls Over Confidential HHS System Information: Community First Health Plans
The audit was conducted to determine whether confidential HHS System information in the custody of Community First and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 2, 2018.