Reports

Assessment and Evaluation Practices at Sunny Springs Nursing and Rehabilitation
The audit objective was to determine whether therapy services at Sunny Springs were provided consistent with physician orders and in accordance with resident assessments and evaluations. Issued October 25, 2017.

Treasury Offset Program
This report details the inspection of procedures to maximize recovery of Supplemental Nutrition Assistance Program overpayments through the Treasury Offset Program. Issued October 20, 2017.

Issue Brief: Value-Based Payments
This issue brief provides an overview of value-based payments, which are structured to incentivize providers to delivery quality care in the most cost-effective manner.

Consolidated SB 30 Report
The Consolidated Senate Bill 30 Annual Report for fiscal year 2017.

PARIS-VA Match Report
The annual PARIS-VA Match Report for fiscal year 2017.

Speech Therapy
This report details the inspection of Texas Medicaid providers to examine MCO controls for prior authorization, best practices to strengthen controls, medical necessity for authorization, and speech therapy utilization rates across managed care service areas. Issued October 2, 2017.

Quarterly Report: Quarter 4, FY 2017
The OIG Quarterly Report for the fourth quarter of fiscal year 2017.

Issue Brief: Recovery of Funds
This issue brief provides an overview of new state and federal guidelines for Medicaid managed care organizations about the recovery of improper payments and how other states distribute recovered Medicaid funds.

Audit of Baylor Scott & White Medical Center – Lake Pointe 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 Lake Pointe Medicare cost report were accurate, allowable, and adequately supported according to CMS and state requirements. Issued August 31, 2017.

Audit of Maxor National Pharmacy Service LLC: A Texas Vendor Drug Program Provider
The audit evaluated Maxor National Pharmacy Service LLC 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 August 31, 2017.

Audit of HEB Pharmacy No. 084: A Texas Vendor Drug Program Provider
The audit evaluated HEB Pharmacy No. 084 to determine whether it properly billed VDP and complied with certain requirements.  Issued August 31, 2017.

Audit of US Bioservices Corporation: A Texas Vendor Drug Program Provider
The audit evaluated US Bioservices 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.  Results indicated no exceptions for the claims tested.  Issued August 29, 2017.

Audit of Security Controls Over Confidential HHS Information System: FirstCare Health Plans
The audit was conducted to determine whether confidential HHS System information in the custody of FirstCare and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued August 22, 2017.

Summary of Results from Audits of Acute Care Utilization Management in Managed Care Organizations: Informational Report
This informational report summarizes acute care utilization management practices in managed care organizations based on the results of four audits performed by the HHSC IG Audit Division. Issued August 15, 2017.

Audit of MedCare Pediatric Group, LP: A Medicaid Speech Therapy Provider
The objectives of the audit were to evaluate whether MedCare complied with certain Texas Medicaid requirements. Issued August 11, 2017.