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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) The office of inspector general may review the records of a managed care organization to which this subchapter applies to determine compliance with this subchapter.
(b) The office of inspector general, in consultation with the commission, shall:
(1) investigate, including by means of regular audits, possible fraud, waste, and abuse by managed care organizations to which this subchapter applies;
(2) establish requirements for providing training to and regular oversight of special investigative units established by managed care organizations under Section 544.0352(a)(1) and entities with which managed care organizations contract under Section 544.0352(a)(2);
(3) establish requirements for approving plans to prevent and reduce fraud and abuse that managed care organizations adopt under Section 544.0353;
(4) evaluate statewide Medicaid fraud, waste, and abuse trends and communicate those trends to special investigative units and contracted entities to determine the prevalence of those trends;
(5) as needed, assist managed care organizations in discovering or investigating fraud, waste, and abuse; and
(6) provide ongoing, regular training to appropriate commission and office staff concerning fraud, waste, and abuse in a managed care setting, including training relating to fraud, waste, and abuse by service providers, recipients, and enrollees. (Gov. Code, Secs. 531.113(d), (d-1).)
Cite this article: FindLaw.com - Texas Government Code - GOV'T § 544.0354. Assistance and Oversight by Office of Inspector General - last updated January 01, 2024 | https://codes.findlaw.com/tx/government-code/gov-t-sect-544-0354/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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