Reports

Issue Brief: Attendant Care Services
This issue brief provides an overview of attendant care services, which provide Medicaid clients the assistance they need to stay in their community, instead of living in a long-term care (LTC) facility.

Audit of Cook Children’s Home Health: A Texas Vendor Drug Program Provider
The audit evaluated Cook Children’s Home Health 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 April 30, 2018.

Audit of R Medical Outreach and Associates: 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. Issued April 27, 2018.

Audit of Medicaid and CHIP MCO SIUs: Driscoll Health Plan
The audit evaluated Driscoll’s policies and practices associated with preventing, detecting, investigating, and reporting fraud, waste, and abuse. Issued April 3, 2018.

Quarterly Report: Quarter 2, FY 2018
The OIG Quarterly Report for the second quarter of fiscal year 2018.

Texas Medicaid and CHIP Managed Care Organizations’ Special Investigative Units Review and Recommendations
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 152). Issued March 29, 2018.

Quarterly Report: Quarter 1, FY 2018
The OIG Quarterly Report for the first quarter of fiscal year 2018.

Review of Managed Care Organizations' Cost Avoidance and Waste Prevention Activities
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 151.) Issued March 1, 2018.

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.