LINCOLN — A pre-Christmas update to the Nebraska Department of Health and Human Services' audit of the program shows that financial benefits have flown through for months for questionable reimbursements for home health care despite increased record-keeping. It turned out that it was.
Some providers may be affected after Nebraska Comptroller Mike Foley's staff scrutinized the state's payment system. The problems come despite DHHS tightening procedures after a state audit in February found inadequate record-keeping and financial controls.
One such provider, Omaha-based Murray's Blessings, received more than $1 million in payments, including amounts that auditors said may be fraudulent. Foley's office said the provider was reimbursed for services to two employees while they were detained or imprisoned on criminal charges.
According to it, Better Business Bureau ProfileMurray's Blessings provides residents with in-home care, including meal preparation, transportation, cleaning, and health-related services.
“This program is flawed”
“There are tens of millions of dollars in the flow of this case, and it's so laxly managed that you could literally go to jail and get paid,” Mr Foley told the Examiner. “This program is flawed and needs serious fixing to protect taxpayers and ensure funds go where they are needed.”
Other highlights from Foley's letter to DHHS CEO Steve Corsi on Wednesday include:
A caregiver at another company received 55 days of compensation for her services at the same time the woman worked at another job in financial technology.
DHHS paid caregivers who worked 88 hours a week while working a third full-time job in county government. That's the equivalent of two full-time jobs, auditors said.
The state paid up to 85.5 hours per week to a caregiver working full-time for a rental management company at the same time. On the 29th, the company was reimbursed for the cost of the home care, but records showed the caregiver had taken another job.
Another caregiver was paid for services while working as a student bus driver and also when attending court hearings. DHHS had already identified caregivers who had previously sought questionable reimbursements.
Some have been previously flagged
Foley compared the frequency of some double charges to the ability of some Catholic saints to be in two places at the same time, saying they cannot be “double-placed.”
He also questioned HHS' process that allows people previously flagged as questionable on Medicaid reimbursement applications to continue receiving payments with minimal scrutiny.
These and other examples are in addition to Foley's original letter to DHHS in February, which pointed to problems with the state's system for compensating people and businesses that provide home care.
Corsi and DHHS said in a statement Wednesday that they agreed with the findings. foley's first letter and made major upgrades to the state's information technology systems.
“We also added two full-time internal auditors, bringing our internal audit team up to six auditors,” Corsi said. “Our department is dedicated to combating fraud and waste.”
NE Auditor: 'Clear fraud', suspected of up to $1.5 million in suspicious billing in DHHS program
The latest audit started with a random sample of 15 claims, with more claims examined if errors were found. HHS's error rate improved from 23% in February to 9% by year's end.
In total, the latest audit found $98,000 in questionable costs in the sample. This is on top of the $54,000 amount identified earlier this year in connection with the same program. Foley estimates that: Possible annual loss Pay more than $1.5 million to the state.
Foley praised Corsi for taking the president's concerns seriously. He said he looks forward to “working together toward a solution that respects our state's taxpayers.”
The Comptroller's Office is sharing allegations of fraud involving state funds with state officials and the Nebraska Attorney General's Office.
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DHHS initial ML_FINAL
