Reports

August 2023

Audit

Edinburg Pediatric Network
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether telemedicine services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 29, 2023. OIG Report No. AUD-23-034.

Audit

Little Spurs Pediatric Urgent Care
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether telemedicine services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 24, 2023. OIG Report No. AUD-23-033.

Audit

Driscoll Children’s Health Plan Special Investigative Unit
Executive Summary

The OIG evaluated whether Driscoll complied with selected state and contractual requirements related to (a) preventing, detecting, and investigating fraud, waste and abuse and (b) reporting reliable information on SIU activities, results and recoveries to the OIG. Issued August 23, 2023. OIG Report No. AUD-23-032.

Audit

Aapex Pharmacy
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 23, 2023. OIG Report No. AUD-23-031.

Audit

Cook Children’s Physician Network
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 21, 2023. OIG Report No. AUD-23-028.

Audit

Follow-Up Assessment on Previously Issued Audit Recommendations: Fee-for-Service Claims Submitted by Aveanna Healthcare Medical Solutions
This follow-up assessment of the previously issued audit report titled “Fee for Service Claims Submitted by Aveanna Healthcare Medical Solutions: A Texas Medicaid Durable Medical Equipment and Supplies Provider” to determine the implementation status of audit recommendations previously issued by OIG Audit. Issued August 21, 2023. OIG Report No. AUD-23-027.

Audit

The PsyClinic: A Texas Medicaid Provider
Executive Summary

The audit objective was to determine whether (a) teleservices provided by the PsyClinic were billed accurately and in accordance with applicable requirements and (b) related internal controls over teleservices were designed and operating effectively. Issued August 18, 2023. OIG Report No. AUD-23-026.

Audit

Parkland Community Health Plan Special Investigative Unit
Executive Summary

The OIG evaluated whether Parkland  complied with selected state and contractual requirements related to (a) preventing, detecting, and investigating fraud, waste and abuse and (b) reporting reliable information on SIU activities, results and recoveries to the OIG. Issued August 11, 2023. OIG Report No. AUD-23-023.

Audit

Express Pharmacy #3
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 8, 2023. OIG Report No. AUD-23-022.

Audit

Administrative and Medical Expenses Reported on Financial Statistical Reports: Texas Children’s Health Plan, Inc.
Executive Summary

The audit objective was to determine whether (a) Texas Children’s Health Plan, Inc. reported expenses on selected components of its 334-day 2021 Medical and Combined financial statistical reports submitted to the Texas Health and Human Services Commission in accordance with contract requirements and laws and (b) the related internal controls over the preparation of the financial statistical reports were designed and operating effectively. Issued August 7, 2023. OIG Report No. AUD-23-018.