Evidence record
Multiple Identification Numbers in Texas Medicaid and CHIP
- Jurisdiction
- Texas
- Publication date
- January 12, 2026
- Source record
- Original document linked
Findings
1
Recommendations
5
Overall conclusion
AES had processes and controls to prevent and detect the creation of multiple IDs and associated overpayments, but improvements can be made to further limit the creation of multiple IDs for Texas Medicaid and CHIP members.
Scope
May 1, 2024 through April 30, 2025; scope includes AES's management of Texas Medicaid and CHIP IDs and merges within TIERS and related overpayments, limited to members enrolled in the STAR program.
Findings (1)
Each finding has a stable link.
- F-1144
AES continued to create multiple IDs for the same individual, resulting in estimated overpayments of $235,642.66 for 119 members identified May 2024–April 2025, and challenges locating existing IDs when biographical information is incorrect.
Recommendations (5)
- R-1018
Compare available information in TIERS on every new application to determine whether an ID already exists and utilize the original ID before approving an applicant.
Related finding F-1144 - R-1019
Review any remaining uncorrected IDs created for the individuals identified in this inspection, merge IDs as applicable, and recover associated overpayments.
Related finding F-1144 - R-1020
Train Data Integrity division staff members to correctly process all required merges, identify overlapping benefit months, and create overpayment referrals.
Related finding F-1144 - R-1021
Update procedures to document the Data Integrity division's secondary review process to verify staff correctly complete all required merges and create overpayment referrals as required.
Related finding F-1144 - R-1022
File an overpayment referral with the OIG for the 42 merges identified with missing overpayment referrals.
Related finding F-1144