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Audit Report (A-06-07-00108)

Medicaid Payments Made for Nonemergency Services Provided to Undocumented Aliens and Legal Aliens Restricted to Emergency Services in Texas

Executive Summary

The Texas Health and Human Services Commission (the State agency) claimed Federal reimbursement for 193 medical claims totaling $262,366 ($160,000 Federal share) and 7,114 prescription drug claims totaling $148,000 ($90,000 Federal share) for services that did not meet the State agency’s definition of emergency care. Additionally, the State agency claimed overpayments totaling at least $37,000 (Federal share) for 350 unallowable family planning services claims at the enhanced Federal medical assistance rate of 90 percent.

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201