Audit at Texas Health and Human Services Commission finds latest in long line of problems

Source: Robert T. Garrett, Dallas News, July 18, 2018

Texas’ sprawling bureaucracy for regulating health care and providing social services is vulnerable to a “perception of impropriety” because it routinely lets individual contracting personnel open bids on their own, without any witnesses, a new internal audit says. The Health and Human Services system also unwisely allows program managers and division leaders who control billions of dollars of spending to ask for the same contracting specialist every time, the audit said. That potentially creates a coziness that could harm taxpayers’ interests, it said. Problems highlighted in the audit, which was released to state GOP leaders last week, are the latest in a long line of problems at the Health and Human Services Commission. Six officials have stepped down since early April, when Gov. Greg Abbott called revelations of sloppiness and mistakes in scoring of bids “unacceptable.” …

Another audit released Tuesday by an independent arm of the Legislature looked at nearly 70 percent of the $6.7 billion worth of contracts that the commission awarded in a recent 27-month period. There were problems with every single one of the 28 separate calls for bids or grant proposals that the State Auditor’s Office examined. … Both the commission’s internal audit and the State Auditor’s Office review sharply criticized sloppy handling and scoring of bids for billions of dollars worth of work for the Medicaid program for the poor and other health and social services programs. …

Related:
Pain & Profit series from the Dallas Morning News, published June 2018

  • The preventable tragedy of D’ashon Morris
    Doctors described him as “happy and playful” and told his foster mother he would be healthy by the time he went to kindergarten. That was before a giant health care company made a decision that saved it as much as $500 a day — and cost D’ashon everything.
  • As patients suffer, companies profit
    Imagine being trapped in a bed for more than a year because you can’t get the medical equipment you need. Years of poor oversight by the state have allowed health care companies to skimp on essential care for sick kids and disabled adults.
  • Texas pays companies billions for ‘sham networks’ of doctors
    The state tells foster parents that hundreds of psychiatrists will see their kids. We found only 34. Managed-care companies overstate the number of physicians available to treat the state’s sickest patients.
  • ‘Glossover of the horror’
    A whistleblower says taxpayers are not getting their money’s worth and sick people are not getting the care they need. Texas fails to act when health care companies put patients in peril.
  • Parents vs. the Austin machine
    “You can tell that he’s crying or screaming, but nothing comes out.” Texas families take fight for medically fragile children to the Legislature.


Report: Privatized Medicaid program serves fewer people, costs more
Source: Brian M. Rosenthal, Houston Chronicle, February 12, 2017

The privatization of a state program that transports poor Texans to medical appointments has cost the state hundreds of millions of dollars more while serving fewer than half as many people, according to a Legislative Budget Board report that some officials tried to withhold from the public. In the five years since Texas began privatizing the management of the Medical Transportation Program, the number of Medicaid recipients using the program has dropped from 350,000 to 150,000, the number of substantiated complaints has doubled, administrative costs have quadruped and the overall per-ride cost to the public has nearly tripled, the report authors found. The privatization effort was designed to reduce fraud, and anti-fraud measures may have caused some of the drop in users. Still, the budget board found, privatization has left out thousands of people and cost taxpayers an estimated $316 million more than would have been spent if the state still was running the program. Despite the problems, and in spite of a promise to put the program out for bid again, the Texas Health and Human Services Commission recently renewed all of the contracts until 2018, the budget board report noted. The problems were caused, in part, by a sloppy procurement process, the report concluded. The Health and Human Services Commission solicited applications from companies to manage different regions of the state, but it picked several firms that its own evaluators had determined were not the best options, according to the report’s authors. …

Read the full report.