Reports

Security Controls Over Confidential HHS System Information: MAXIMUS Enrollment Broker
The audit evaluated the design and effectiveness of selected security controls over confidential HHS System information stored and processed by MAXIMUS. Issued February 23, 2018.

Audit of Southside Pharmacy: A Texas Vendor Drug Program Provider
The audit evaluated Southside Pharmacy 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 February 9, 2018; revised February 28, 2018.

Recoveries Accountability Report
This report was submitted to the Legislative Budget Board and the Governor in compliance with the 2018-2019 General Appropriations Act, Senate Bill 1, 85th Legislature, Regular Session, 2017 (Article II, Health and Human Services Commission, Rider 153). Issued February 1, 2018.

Audit of Gaddy Enterprises: A Durable Medical Equipment Provider
The audit evaluated whether fee-for-service claims for incontinence supplies paid with Medicaid funds were billed in accordance with state laws, regulations, and program requirements.  Test results indicated no exceptions. Issued December 20, 2017.

Homelife and Community Services, Inc.: A Texas Home and Community-Based Services Program Provider
This audit evaluated whether claims for Residential Support Services submitted by and paid to Homelife and authorizations for billed Day Habilitation services existed were properly documented. Issued November 30, 2017.

Audit of Children’s Hope Residential Services, Inc.: Residential Child-Care Contracts with The Texas Department of Family and Protective Services
The audit evaluated whether state funds were used as intended for facility maintenance and payments to foster parents and whether Children’s Hope met contract requirements for supervising children, performing inventories, and documenting services. Issued November 30, 2017.

Audit of Wee-Care Pediatric Specialty Therapeutic: A Medicaid Speech Therapy Provider
The audit evaluated whether Wee-Care complied with Texas Medicaid requirements for speech therapy claims billing, prior authorizations, speech therapy duration and total number of visits, and credentialing of speech language pathologist assistants and interns. Issued November 20, 2017.

Joint OIG-MFCU Report
The Joint Annual Report on Fraud and Abuse in Medicaid, compiled by IG and the Attorney General's Medicaid Fraud Control Unit, for fiscal year 2017.

Pharmacy Benefit Managers in Texas: Informational Report on the Role of PBMs in Delivering Medicaid and CHIP Pharmacy Benefits to Managed Care Members
This report describes the functions and components of PBMs in delivering pharmacy services, responsibilities for related performance and oversight, and how the components interact with each other to delivery pharmacy services. Issued November 17, 2017; revised September 30, 2019.

Audit of HALO-Flight: A Texas Air Ambulance Provider
The audit evaluated HALO-Flight fee-for-service claims for air ambulance services were billed in accordance with state laws, regulations, and the Texas Medicaid Provider Procedures Manual.  Results indicated no exceptions for the claims tested.  Issued November 15, 2017.

HHSC Processes for Analyzing and Preventing Eligibility Determination Errors
The audit objective was to evaluate activities designed to analyze eligibility determination errors for benefit programs managed by the Texas Health and Human Services (HHS) System. Issued November 13, 2017.

SSLC Investigations Report
The Annual Report of State Supported Living Center Investigations for fiscal year 2017.

State Hospital Investigations Report
The Annual Report of State Hospital Investigations for fiscal year 2017.

MCO Fraud Recoveries Report
The Annual Report on Certain Fraud and Abuse recoveries for fiscal year 2017.

Audit of Providence Memorial Hospital Cost Report: Fiscal Year 2014
The audit objective was to determine whether the amounts in the capitalization and moveable equipment cost centers reported on the Providence Memorial Hospital cost report were accurate, allowable, and adequately supported according to CMS and state requirements. Issued October 31, 2017.