Reports

Fraud and Abuse Prevention: Home Health Aides
This article explains how to prevent being the target of fraud or abuse in your home. Issued February 15, 2019.

Budget Presentation to House Appropriations Subcommittee on Article II
The OIG presentation given to the House Appropriations Subcommittee on Article II on February 12, 2019.

Audit of Metscript Pharmacy No. 2: A Texas Vendor Drug Program Provider
The audit evaluated Metscript Pharmacy No. 2 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 11, 2019.

Budget Presentation to Senate Finance Committee
The OIG presentation given to the Senate Finance Committee on February 5, 2019.

Issue Brief: Encounter Data
This Issue Brief outlines how the OIG uses encounter data (a record of paid claims by MCOs and DMOs) to monitor and detect fraud, waste, and abuse. Issued January 17, 2019.

Personal Care Services: Inspection of Attendant Background Checks
This report details the inspection to determine if home health providers obtain and evaluate background information on attendant care personnel to ensure client safety. Issued January 16, 2019.

Automated Monthly Social Security Number Verification
This report details the inspection to determine if HHSC Access and Eligibility Services properly addresses non-verified Social Security numbers to prevent ineligible client enrollment in Texas Medicaid. Issued January 3, 2019.

Quarterly Report: Quarter 1, FY 2019
The OIG Quarterly Report for the first quarter of fiscal year 2019.

Bethesda Lutheran Homes and Services: A Texas Medicaid Home and Community-Based Services Program Provider
This audit evaluated whether fee-for-service claims submitted by and paid to Bethesda Lutheran were authorized, documented, and billed in accordance with the HCS provider agreement and with state rules and guidelines. Issued December 14, 2018.

Audit of Lakes Regional MHMR Center: A Texas Medicaid Home and Community-Based Services Program Provider
This audit evaluated whether claims for residential support services and supervised living submitted by and paid to Lakes Regional and authorizations for other HCS services existed were properly documented. Issued November 30, 2018.

Audit of Avita Drugs: A Texas Vendor Drug Program Provider
The audit evaluated Avita Drugs 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 November 30, 2018.

Audit of Security Controls Over Confidential HHS System Information: Amerigroup Texas, Inc.
The audit was conducted to determine whether confidential HHS System information in the custody of Amerigroup and its subcontractors was protected from unauthorized access, loss, or disclosure. Issued November 30, 2018.

Audit of Mission Road Developmental Center: A Texas Medicaid Home and Community-Based Services Program Provider
This audit evaluated whether claims for residential support services and supervised living submitted by and paid to Mission Road and authorizations for other HCS services existed were properly documented. Issued November 30, 2018.

Audit of Passage of Youth Family Center: Child-Placing Agency Residential Child-Care Contract with the Texas Department of Family and Protective Services
The audit evaluated Passage of Youth to determine whether it (a) used state funds as intended for foster children, (b) conducted oversight of foster parents, and (c) implemented and updated children’s service plans. Issued November 30, 2018.

Audit of Cystic Fibrosis Services, Inc.: A Texas Vendor Drug Program Provider
The audit evaluated Cystic Fibrosis Services, Inc. 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 November 26, 2018.