Evidence record
An Audit Report on The Health and Human Services Commission’s Oversight of the Medical Transportation Program
- Jurisdiction
- Texas
- Publishing agency
- Texas State Auditor's Office
- Publication date
- March 2022
- Source record
- Original document linked
Findings
4
Recommendations
5
Overall conclusion
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.
Scope
The scope of this audit covered the Texas Health and Human Services Commission’s processes and controls related to transportation program claims data, transportation supporting documentation, transportation provider contracts, complaints, accident/incidents, and contract monitoring documentation between September 1, 2019, and March 31, 2021. The audit also covered the transition of the program to Medicaid Managed Care Organizations, including transition supporting documentation, through August 31, 2021, and included a review of significant internal control components related to the Commission’s oversight of the transportation program.
Findings (4)
Each finding has a stable link.
- F-034
The Commission's desk review processes had significant weaknesses, including untimely reviews and improperly designed review reports.
- F-033
The Commission did not always effectively monitor transportation claims to verify that clients received the services and that mileage claims were supported and allowable.
- F-035
The Commission's monitoring of provider-reported accidents/incidents was adequate, but it did not ensure that client-reported accidents/incidents were properly investigated and recorded.
- F-036
The Commission's process for monitoring client complaints was generally effective, but it should improve to ensure complaints are closed within established timeframes.
Recommendations (5)
- R-038
Resuming and enhancing operational reviews to verify documentation supporting claims and client enrollment.
Related finding F-034 - R-039
Strengthening desk review processes, including establishing due dates, redesigning reports, and developing secondary review processes.
Related finding F-034 - R-040
Improving data accuracy and completeness in accident/incident and complaint databases.
Related finding F-035 - R-041
Developing policies for timely application of corrective actions and liquidated damages.
Related finding F-036 - R-042
Creating a centralized oversight workgroup to improve monitoring and oversight activities.