Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-06-14-00002
Report Description
Not all of the direct medical service costs that the Texas Health and Human Services Commission (State agency) claimed for Medicaid School Health and Related Services (SHARS) were reasonable, adequately supported, and otherwise allowable in accordance with applicable Federal and State requirements. Specifically, Fairbanks, LLC (the Contractor), coded random moments incorrectly. Of the 3,161 random moments coded as an Individualized Education Plan-covered direct medical service, 274 were coded incorrectly. As a result of these errors, the State agency received $18.9 million in unallowable Federal reimbursement for the Medicaid SHARS program during the period October 1, 2010, through September 30, 2011.
Report Type
Audit
Location
TX
United States
Number of Recommendations
2
Questioned Costs
$18,925,853
Funds for Better Use
$0
Additional Details
