Reports

Executive Summary

The audit objective was to evaluate whether Girling (a) developed and performed individualized service plans, (b) performed visit maintenance for selected EVV transactions in accordance with selected regulations, and (c) performed selected oversight activities. Issued August 12, 2022. OIG Report No. AUD-22-020

Executive Summary

The audit objective was to determine whether the City of Houston Health Department had processes and controls in place to ensure it administered the STD/HIV Prevention Services Grant Program in accordance with selected grant agreement requirements for performance, data management, reporting, and grant expenditures. Issued August 11, 2022. OIG Report No. AUD-22-018.

Executive Summary

The inspection objective was to determine whether the direct care licensed nursing hours recorded at Westchase Health and Rehabilitation Center supported the hours submitted to the U.S. Centers for Medicare and Medicaid Services in compliance with federal requirements. Issued August 9, 2022. OIG Report No. INS-22-006.

Executive Summary

The inspection objective was to determine whether the direct care licensed nursing hours recorded at Winchester Lodge Healthcare Center supported the hours submitted to the U.S. Centers for Medicare and Medicaid Services in compliance with federal requirements. Issued August 9, 2022. OIG Report No. INS-22-007.

The OIG Audit and Inspections Division contracted Myers and Stauffer LC to audit whether pharmacy claims billed and paid under the state Medicaid program were in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued July 25, 2022.

Executive Summary

The audit objective was to determine whether Dallas County Health and Human Services had processes and controls in place to ensure it administered the STD/HIV Prevention Services Grant Program in accordance with selected grant agreement requirements for performance, data management, reporting, and grant expenditures. Issued August 2, 2022. OIG Report No. AUD-22-017.

The audit assessed the design and effectiveness of selected security controls over confidential HHS System information stored and processed by Scott and White Health Plan. Issued July 22, 2022. OIG Report No. AUD-22-015.

Executive Summary 

OIG evaluated whether Matagorda House, advertising as a memory care facility, provided services delivered and operated in compliance with applicable laws, rules, and guidelines. Issued July 22, 2022. OIG Report No. AUD-22-016.
 

Executive Summary

The audit objective was to determine whether the San Antonio Metropolitan Health District had processes and controls in place to ensure it administered the STD/HIV Prevention Services Grant Program in accordance with selected grant agreement requirements for performance, data management, reporting, and grant expenditures. Issued July 15, 2022. OIG Report No. AUD-22-014.

Executive Summary

This inspection examined the processes Cook Children’s Health Plan, El Paso Health, and Superior HealthPlan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 12, 2022. OIG Report No. INS-22-005.

Executive Summary

This inspection examined the processes Amerigroup, Blue Cross and Blue Shield of Texas, Dell Children’s Health Plan, Molina Healthcare of Texas, and United Healthcare Community Plan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 12, 2022. OIG Report No. INS-22-004.

Executive Summary

This inspection examined the processes Aetna Better Health of Texas, Community First Health Plans, Driscoll Health Plan, and Parkland Community Health Plan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 11, 2022. OIG Report No. INS-22-003.

Executive Summary

This inspection examined the processes Community Health Choice, FirstCare HealthPlans, Scott & White Health Plan, and Texas Children’s Health Plan have for ensuring laboratory service providers have the appropriate CLIA certification prior to paying submitted claims. Issued July 11, 2022. OIG Report No. INS-22-002.

The IG Quarterly Report for the third quarter of fiscal year 2022.

Executive Summary

OIG evaluated whether Silverado Barton Springs, advertising as a memory care facility, provided services delivered and operated in compliance with applicable laws, rules, and guidelines. Issued June 3, 2022. OIG Report No. AUD-22-013.