Reports

December 2023

Other

Joint Annual Interagency Coordination Report
The Joint Annual Interagency Coordination Report summarizes the collaborative activities of the HHS Office of Inspector General and Office of Attorney General Civil Medicaid Fraud Division and Medicaid Fraud Control Unit in the detection and prevention of fraud, waste and abuse in Texas Medicaid

Audit

About OIG Audit reports
Final audit reports are posted to the OIG website when issued. These reports are subject to appeal upon timely, written, proper requests for appeal, as provided for in rule. These final audit reports are public records and remain posted on the website during and after an appeal.

November 2023

Audit

Baylor Scott & White Health: A Texas Medicaid Provider
Executive Summary The audit objective was to determine whether (a) teleservices provided by Baylor Scott & White Health were billed accurately and in accordance with applicable requirements and (b) related internal controls over teleservices were designed and operating effectively. Issued November 29, 2023. OIG Report No. AUD-24-002.

October 2023

September 2023

Audit

Managed Care Pharmacy Encounters Paid to Bemaj Pharmacy, Inc.: A Managed Care Network Provider Contracted Under Amerigroup Texas, Inc., Amerigroup Insurance Company, and Superior HealthPlan, Inc.
Executive Summary

The audit objective was to determine whether Bemaj Pharmacy, Inc. (a) properly billed for selected paid encounters associated with Texas Medicaid members enrolled with Amerigroup and Superior and (b) complied with applicable contractual, state, and federal requirements. Issued September 1, 2023. OIG Report No. AUD-24-001.

August 2023

Audit

Rolling Audit and Inspections Plan 2024
The OIG has updated its Rolling Audit and Inspections Plan, which outlines potential audit and inspections areas and topics.The OIG Audit and Inspections Division conducts a continuous risk assessment to identify potential topics for inclusion in its Rolling Audit and Inspections Plan. Potential audit and inspections topics consist of programs, services, providers and contractors with an elevated potential for fraud, waste and abuse.