An audit says state workers failed to justify not collecting millions of dollars worth of health services provided to Nebraskans.
NANCY HICKS / Lincoln Journal Star | Posted: Sunday, December 2, 2007 6:00 pm
The state may have lost millions of dollars in private payments for heath services because state employees did not do a good job of collecting debt or of verifying individual income and ability to pay.
But the Department of Health and Human Services is taking steps to do a better job of determining who owes the state money for services and in collecting that money, Gov. Dave Heineman said Monday at a joint news conference with Auditor Mike Foley.
The two men talked about collection problems at the state’s three psychiatric hospitals, and at programs for children and adults with developmental disabilities in local communities and the Beatrice State Developmental Center.
The state has hired an Omaha auditing firm, Sein, Johnson, Sestak and Quist, to help create a better verification and collection system and a national collection firm, NCO, to get money from reluctant responsible parties in response to Foley’s audit issues, according to Chris Peterson, CEO of HHS.
Specific problems included late billings to insurance companies, no verification of parental income for children getting state-sponsored services and little attempt to collect money from parents or other responsible parties beyond sending monthly statements.
The audits uncovered specific examples of families with substantial incomes and resources who were not being properly assessed based on their ability to pay:
n In one instance, an Omaha family owned an expensive home, multiple expensive vehicles, including two large motor homes, and had a Nebraska taxable income in excess of $829,000. The family submitted a payment to DHHS for services, and the state declined the check and returned it un-cashed, citing the family had an undue hardship.
n One family receiving services owned $750,000 in real estate and seven vehicles but did not provide any financial information, and HHS was not pursuing collection.
n Staff at BSDC adjusted clients’ ability to pay to zero when no financial information was provided within three months. But Nebraska regulations require that clients be billed at full cost if no financial information is provided.
But there were other cases in which parents who likely could not pay were billed for thousands of dollars.
n One mother, who had been on Medicaid for a portion of the time, had been billed $192,000 for the care of a child since 1997.
Auditors and HHS business staff say they don’t know exactly how much money may have been lost because of the state’s inept collection and verification processes.
The audit uncovered around $16 million in uncollected payments for these health care services, but it is impossible to tell how much of this is debt that could be collected and how much is simply the result of verification and paperwork problems.
Foley’s staff uncovered the sloppy work during a 2006 fiscal year audit. Based on the audit, the governor’s team took steps to improve its verification and collection processes, according to Heineman and Foley.
“The report is not happy reading,” said Foley during the news conference. “However, it is a pleasure to work with people who genuinely want to know where the problems are so that together we can get them fixed.”
Heineman said he has challenged HHS “to become more accountable and improve services.”
The audits gave HHS the opportunity to make improvements, he said.
HHS has determined that some employees may not have been doing their job and are “taking appropriate disciplinary action,” said Peterson, HHS chief executive officer.
Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.