Quarterly Report: Quarter 4, FY 2017
The OIG Quarterly Report for the fourth quarter of fiscal year 2017.
September 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.
August 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 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 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.
Audit of Houston Medicine Chest, LLC: A Texas Vendor Drug Program Provider
The audit evaluated Houston Medicine Chest, 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 3, 2017.
July 2017
Pediatric Dental Sedation
This report details the inspection of Texas Medicaid providers to determine if dental sedation procedures performed on Medicaid pediatric patients are medically necessary and meet the standard of care. Issued July 14, 2017.
June 2017
Quarterly Report: Quarter 3, FY 2017
The OIG Quarterly Report for the third quarter of fiscal year 2017.
May 2017
Dental Service Organizations: Informational Report
The IG Audit Division has completed this informational report, Dental Service Organizations, to gain an understanding of DSOs and how they support the delivery of dental services provided to Medicaid and CHIP-eligible individuals. Issued May 31, 2017. Revised November 14, 2017.
Opioid Drug Utilization
This report details the inspection of Texas Medicaid efforts to reduce prescription opioid abuse and overutilization. Issued May 30, 2017.
Audit of the University of Texas Medical Branch at Galveston Cost Report: Fiscal Year 2014
The IG Audit Division has completed Audit of the University of Texas Medical Branch at Galveston Cost Report: Fiscal Year 2014. This report contains the results of an audit to determine whether selected cost centers reported on the Medicare cost report were accurate, allowable, and adequately supported according to Centers for Medicare and Medicaid (CMS) and state requirements. Issued May 30, 2017.