The Nebraska Department of Health and Human Services (DHHS) recently came under scrutiny following an audit that uncovered nearly $20,000 in questionable payouts to caregivers for seemingly impossible work hours.
Among the notable instances was a caregiver who purportedly worked 66 hours weekly while maintaining a full-time job as a school bus driver. Another claimed 118 hours weekly across three clients, and a third caregiver billed more than 24 hours each day over a 45-day span within three months.
“Some of these people are making the Energizer Bunny look like a slacker, because there’s just so many hours in the day,” commented State Auditor Mike Foley. “You’ve got to sleep sometime, and if you’re putting in 80 hours a week caring for someone, you’re obviously not able to also hold down full-time employment somewhere else.”
An examination of a random sample of five caregivers revealed that all received improper payments, suggesting a broader issue, as Foley pointed out. “If you take the just the findings of those handful that were in the sample and extrapolate it out, I’m sure we’re talking about a very significant sum of money,” he said.
Additionally, other DHHS programs have been under the audit spotlight for similar issues. In September, a report highlighted problems with autism service providers, which received $85 million in 2024. These providers submitted duplicate invoices and often lacked proper documentation or credentialed staff.
Last year, another audit revealed that over 1,000 child care providers incorrectly billed the state, leading to up to $128 million in improper payments, as detailed here.
The personal assistance services program, a frequent audit target, was previously found to have approximately $1.5 million in questionable payments due to fraudulent claims of working hours, as noted in a report.
These findings come from the annual federal single audit, which assesses state spending of around $5 billion in federal funds. Foley warned that such fraud could jeopardize future funding, stating, “It might mean some penalties back to the state. It might mean some recoupment of some of those federal funds. It might mean a reduction in future federal funds.”
Despite these challenges, Foley expressed confidence in DHHS director Steve Corsi, appointed in 2023, to improve the agency’s culture. “It’s just hard to change a culture in an agency that large, but he’s working at it, and I think he’s making progress, and I have confidence in him,” Foley added.
In response, DHHS outlined several measures it has implemented to combat fraud, including systematic controls requiring GPS/IVR visit verification and recipient signatures for claim payments. Moreover, in late June, the department introduced procedures limiting billable hours for client services. However, many improper billings identified in the audit occurred before these changes.
