Helpful Links and Resources

Quality Review Section

Resources and Training

• Regulations affecting Quality Review
• Screening Criteria
• CARE form
• General Long Term Care Resource
• TILE training

Sub-recipient Financial Review Unit

• Uniform Grants Management Standards (UGMS) and State of Texas Single Audit Circular
• Office of Management and Budget (OMB) Circular A-21 – Educational Institutions
• OMB Circular A-87 – State, Local and Indian Tribal Governments
• OMB Circular A-122 – Non-Profit Organizations
• OMB Circular A-102 - State and Local Governments
• OMB Circular A-110 – Educational Institutions, Hospitals and Non-Profit Organizations
• OMB Circular A-133 – Audits of States, Local Governments and Non-Profit Organizations
• 45 CFR 92 – Administrative Requirements (Common Rule) for State and Local Governments (select CFR)
• 45 Code of Federal Regulations (CFR) Part 74 – Administrative Requirements (Common Rule) for Educational Institutions, Hospitals, Non-Profit Organizations, Commercial Organizations and Certain Agreements with State and Local Governments and Indian Tribal Governments (select CFR)
• Financial Administrative Procedures Manual and Appendices, In-Kind Match Documentation Requirements
• Public Health Services (PHS) Grants Policy Statement (applies to certain Department of Health and Human Services grants and sub grants)

WIC Fiscal Monitoring Links

• WIC Website
• WIC Policy Manual
• DSHS Performance Management

Single Audit Links

• OMB Circular A-133
• State of Texas Single Audit Circular (Part IV, UGMS)

Medicaid/CHIP Audits

• Centers for Medicare and Medicaid Services
• Health and Human Services Commission Medicaid Program
• Texas Medicaid and Healthcare Partnership
• Social Security Act, Title XIX
• Maximus
• Institute for Child Health Policy, University of Florida

To check the Medicaid Provider Exclusion list

Third Party Payment Authority
Key areas of authority allowing the State to pursue third party payments include:

• Human Resources Code Chapter 32, §32.033
• 1 TAC Chapter 354, Subchapter J Medicaid Third Party Recovery
• Code of Federal Regulations Chapter IC Part 433 Subpart D Section 433.135 – 433.154

Medicaid Provider Integrity Authority

MPI's statutory authority comes from the following:

Texas Human Resources Code, Chapter 32 and 36

Texas Government Code 531.001 et seq

Texas Occupations Code, Chapter 102

42 United States Code(USC)

Social Security Act

MPI regulatory authority comes from the following:

1 Texas Administrative Code (TAC), Sections 371.1601 – 371.1675

42 Code of Federal Regulations(CFR)

Related Links and Resources

Texas Medicaid and Healthcare Partnership (TMHP)
State Board of Medical Examiners
State Board of Dental Examiners
Board of Vocational Nurse Examiners (LVN)
Board of Nurse Examiners (RN)
Texas State Board of Pharmacy
Optometry Board
Board of Examiner for Psychology
Center for Medicare and Medicaid Services
Texas Workforce Commission
United States Department of Health and Human Services
Attorney General's Medicaid Fraud Control Unit

Identity Fraud

National White Collar Crime Center
Federal Trade Commission
United States Secret Service
Texas Department of Public Safety

This page was last updated on 01/27/2005