Audit of Shield Denver Health Care Centers: A Durable Medical Equipment Provider
The OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued June 27, 2018.
June 2018
Audit of Pharmacy Inventory Controls: Richard's Pharmacy
The OIG Audit Division performed an inventory of selected drugs to determine whether Richard's Pharmacy correctly billed Medicaid, complied with requirements, and maintained sound controls over its related IT systems for the audit period. Issued June 27, 2018.
Audit of Jordan Health Services: A Home Health Provider
The OIG Audit Division contracted Health Management Systems to audit personal care assistance records to verify services provided to recipients, paid by Texas Medicaid. Issued June 13, 2018.
Audit of Jordan Health Services: A Home Health Provider
The OIG Audit Division contracted Health Management Systems to audit personal care assistance records to verify services provided to recipients, paid by Texas Medicaid. Issued June 13, 2018.
Audit of Therapy 2000: A Texas Medicaid Speech Therapy Provider
The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.
Audit of Epic Pediatric Therapy (Austin) : A Texas Medicaid Speech Therapy Provider
The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.
Audit of Epic Pediatric Therapy (Dallas) : A Texas Medicaid Speech Therapy Provider
The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.
Audit of Epic Pediatric Therapy (Dallas) : A Texas Medicaid Speech Therapy Provider
The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients, paid by Texas Medicaid. Issued June 12, 2018.
Multiple Medicaid Identification Numbers
This report details the inspection to determine if Texas Medicaid made multiple capitation payments for clients with multiple Medicaid ID numbers. Issued June 8, 2018.
May 2018
Audit of Specialty Therapeutic Care: A Texas Vendor Drug Program Provider
The audit evaluated Specialty Therapeutic Care 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 May 31, 2018.
Medicaid Payments for Deceased Clients
This report details the inspection of capitation payments made for deceased clients in the Texas Medicaid system, to determine how processes can be strengthened to identify and recoup those payments. Issued May 29, 2018.
Electronic Visit Verification System
This report details the inspection of the Electronic Visit Verification (EVV) System to determine how effective it is at verifying that home visits for Medicaid clients occurred and at confirming that home services were provided. Issued May 29, 2018.
Audit of Tropical Texas Behavioral Health: A Texas Behavioral Health Services Provider
The OIG Audit Division contracted Health Management Systems to audit behavioral health records to verify services provided to recipients, paid by Texas Medicaid. Issued May 25, 2018.
Audit of St. Louis Medical Supply: A Durable Medical Equipment Provider
The OIG Audit Division contracted Health Management Systems to audit durable medical equipment records to verify services provided to recipients, paid by Texas Medicaid. Issued May 25, 2018.
Audit of Circle of Care: A Texas Medicaid Speech Therapy Provider
The OIG Audit Division contracted Health Management Systems to audit speech therapy records to verify services provided to recipients paid by Texas Medicaid. Issued May 25, 2018.
Assessment and Evaluation Practices at Mission Nursing and Rehabilitation Center
The audit evaluated Minimum Data Set (MDS) assessments, therapy services charts, medical records, Resource Utilization Group (RUG) levels assigned to residents, and physician orders and certifications for therapy services. Issued May 11, 2018.
Assessment and Evaluation Practices at Mission Nursing and Rehabilitation Center
The audit evaluated Minimum Data Set (MDS) assessments, therapy services charts, medical records, Resource Utilization Group (RUG) levels assigned to residents, and physician orders and certifications for therapy services. Issued May 11, 2018.
IG Presentation to House Human Services Committee: May 9, 2018
This presentation was made by Inspector General Sylvia Hernandez Kauffman on the topic of program integrity in managed care.