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September 19, 2019      2:42 PM

Trio of audits out from HHSC OIG

The Inspector General at the Health and Human Service Commission issued three reports this week that echo complaints about managed health care plans lodged by critics last session.

HHSC’s shift of health care services to a managed care model left a lot of issues on the table for discussion during last session: transparency in pharmacy benefits (Senate Bill 1096, passed); sufficiency of managed care services and benefits (Senate Bill 1105, failed); and protections for denial of service to low-income residents (House Bill 2453, failed.)

Plenty of people in hearings at the Texas Capitol last session – especially the parents of medically fragile children -- complained about the insufficiency of managed care networks, especially for specialized services. HHSC has insisted networks have been adequate.

Now a trio of OIG reports are out with somewhat related subject headings. The outcomes of these reports – Is there a good guy and a bad guy here? – are not always so obvious. Here’s a summary of the three reports:

By Kimberly Reeves

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