Reports

August 2024

Audit

Managed Care Pharmacy Encounters Paid to Omnicare Pharmacy
Executive Summary - The audit objective was to determine whether Omnicare Pharmacy (a) properly dispensed prescriptions associated with selected encounters for Texas Medicaid members enrolled with Superior HealthPlan, Inc., UnitedHealthcare Community Plan of Texas, L.L.C., and UnitedHealthcare Insurance Company, Inc., and (b) complied with applicable contractual, state, and federal requirements. Issued August 28, 2024. OIG Report No. AUD-24-029.

Audit

Managed Care Pharmacy Encounters Paid to Meadowbrook Pharmacy
Executive Summary - The audit objective was to determine whether Meadowbrook Pharmacy (a) properly dispensed prescriptions associated with selected encounters for Texas Medicaid and CHIP members enrolled with Cook Children’s Health Plan, Wellpoint Texas, Inc., and Wellpoint Insurance Company and (b) complied with applicable contractual, state, and federal requirements. Issued August 23, 2024. OIG Report No. AUD-24-027.

Audit

ReCept Pharmacy #31
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether pharmacy claims billed and paid under the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 20, 2024. OIG Report No. AUD-24-025.

Audit

Pediatric Home Service
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether paid MCO medical supply claims billed to, and paid under, the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies and contractual requirements. Issued August 15, 2024. OIG Report No. AUD-24-023.

Audit

Comfort & Care Medical Supplies, Inc.
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether paid MCO DME and medical supply claims billed to, and paid under, the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies and contractual requirements. Issued August 15, 2024. OIG Report No. AUD-24-022.

Audit

Nueva Vida Behavioral Health Associates
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether behavioral health claims billed to, and paid under, the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies and contractual requirements. Issued August 8 2024. OIG Report No. AUD-24-021.

Audit

Alaniz Counseling and Behavioral Center, PC
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether behavioral health claims billed to, and paid under, the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies and contractual requirements. Issued August 8 2024. OIG Report No. AUD-24-020.

Audit

Managed Care Pharmacy Benefit Services- Navitus Health Solutions, LLC
Executive Summary - The audit objective was to determine whether Navitus (a) completed and reported payments and reimbursements for Texas Medicaid and CHIP managed care pharmacy benefit services accurately and in accordance with applicable requirements and (b) effectively designed and operated related internal controls over payments and reporting. Issued August 7, 2024. OIG Report No. AUD-24-018

July 2024

Audit

Pharmacy Alternatives, LLC
The OIG Audit and Inspections Division contracted Myers and Stauffer LC to determine whether pharmacy claims billed and paid under the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued July 31, 2024. OIG Report No. AUD-24-017.