1. (a) The OIG plans and conducts regular audits of MCOs participating in Medicaid according to policy established pursuant to §353.6(d) of this title (relating to Audit of Managed Care Organizations).

2. (b) The OIG coordinates with HHSC in the development of risk assessments, audit plans, and findings to:

   1. (1) minimize the duplication of activities relating to the audits of MCOs; and
   2. (2) ensure that the OIG has a thorough understanding of the health and human services system for purposes of knowledgeably and effectively performing audits of MCOs.
3. (c) To facilitate coordination between the OIG and HHSC, the OIG annually develops and submits to HHSC's Executive Commissioner a draft audit plan identifying the OIG's planned audits of MCOs. The OIG considers input from HHSC, and previous audits and review findings of MCOs by HHSC, before finalizing the annual audit plan.
4. (d) Notwithstanding subsections (a), (b), and (c) of this section, the OIG may investigate, including by means of regular audits, allegations of suspected fraud, waste, or abuse by MCOs.

Source Note:The provisions of this §371.37 adopted to be effective July 14, 2016, 41 TexReg 5039.