Publishing agency

Texas State Auditor's Office

Reports attributed to this exact publisher identity in the indexed source metadata.

Evidence register

7 reports

Published: Sep 1, 2023
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 48

An Actuarial Analysis Of The Health And Human Services Commission’s Fiscal Year 2024 Medicaid Managed Care Rates Actuarial Soundness

The FY 2024 Texas Medicaid managed care capitation rates are actuarially sound overall, with no material program-wide under- or over-funding detected. Milliman identifies several recommendations to strengthen the rate-setting process and reduce future risk, and notes that CMS…

Findings: 7
Recommendations: 7

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Source status: Original source

Published: Oct 2022
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 114

An Audit Report on the Health and Human Services Commission's Medicaid Managed Care Rate-Setting Process

Milliman concluded that FY2023 capitation rates were actuarially sound, with no program-wide pattern of under- or over-funding, though improvements were recommended in several rate-setting and governance processes.

Findings: 7
Recommendations: 5

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Source status: Original source

Published: Jul 2022
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 8

An Audit Report on Cook Children’s Health Plan, a Managed Care Organization

Cook Children’s Health Plan accurately reported STAR Kids medical and pharmacy expenses in FY 2020 and complied with eligibility requirements for medical and pharmacy claims. However, improvements are needed in reporting shared administrative expenses, particularly those alloc…

Findings: 1
Recommendations: 1

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Source status: Original source

Published: Mar 2022
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 10

An Audit Report on The Health and Human Services Commission’s Oversight of the Medical Transportation Program

The audit identified strengths in some areas but also significant weaknesses that could affect the program's integrity and compliance. The Commission has committed to implementing recommended improvements.

Findings: 4
Recommendations: 5

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Source status: Original source

Published: Jun 25, 2021
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 7

An Audit Report on Blue Cross Blue Shield of Texas, a Managed Care Organization

The audit found that while the Health Plan accurately reported medical, administrative, and quality improvement expenses, its pharmacy expense reporting was flawed due to unallowable practices by the Pharmacy Benefit Manager, which could impact Medicaid costs and program integ…

Findings: 5
Recommendations: 3

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Source status: Original source

Published: Jan 2019
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 6

An Audit Report on Medicaid Managed Care Contract Processes at the Health and Human Services Commission

The audit found that the Health and Human Services Commission has made significant progress in establishing processes and controls related to Medicaid managed care contract management, in compliance with Senate Bill 894. However, some planned improvements are still in progress…

Findings: 5
Recommendations: 5

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Source status: Original source

Published: Jan 19, 2019
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 26

Medicaid Managed Care Contract Processes at the Health and Human Services Commission

The Commission has made significant progress in establishing processes and controls for Medicaid managed care contract management, aligning with Senate Bill 894 requirements. However, further efforts are needed to fully implement planned audits, monitoring activities, and IT c…

Findings: 4
Recommendations: 6

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Source status: Original source