Reports

December 2023

Quarterly

Quarterly Report: Quarter 1, FY 2024
The OIG published its first quarterly report for fiscal year 2024, summarizing the agency’s work and results achieved between September 1 and November 30, 2023.

November 2023

Audit

Baylor Scott & White Health: A Texas Medicaid Provider
Executive Summary - The audit objective was to determine whether (a) teleservices provided by Baylor Scott & White Health were billed accurately and in accordance with applicable requirements and (b) related internal controls over teleservices were designed and operating effectively. Issued November 29, 2023. OIG Report No. AUD-24-002.

October 2023

September 2023

Audit

Managed Care Pharmacy Encounters Paid to Bemaj Pharmacy, Inc.: A Managed Care Network Provider Contracted Under Amerigroup Texas, Inc., Amerigroup Insurance Company, and Superior HealthPlan, Inc.
Executive Summary - The audit objective was to determine whether Bemaj Pharmacy, Inc. (a) properly billed for selected paid encounters associated with Texas Medicaid members enrolled with Amerigroup and Superior and (b) complied with applicable contractual, state, and federal requirements. Issued September 1, 2023. OIG Report No. AUD-24-001.

August 2023

Audit

Rolling Audit and Inspections Plan 2024
The OIG has updated its Rolling Audit and Inspections Plan, which outlines potential audit and inspections areas and topics.The OIG Audit and Inspections Division conducts a continuous risk assessment to identify potential topics for inclusion in its Rolling Audit and Inspections Plan. Potential audit and inspections topics consist of programs, services, providers and contractors with an elevated potential for fraud, waste and abuse.

Audit

Roberto Canales M.D.P.A.
The OIG Audit and Inspections Division contracted Weaver and Tidwell to determine whether telemedicine services billed and paid under the state Medicaid program were provided in accordance with applicable state and federal Medicaid laws, regulations, rules, policies, and contractual requirements. Issued August 31, 2023. OIG Report No. AUD-23-036.