LINCOLN— Nebraska Auditor Mike Foley found serious billing and oversight concerns in the state’s Medicaid Aged and Disabled Waiver program, which helps older adults and people with disabilities receive care at home or in community settings. Spending on the program has increased nearly 600%, from about $65 million in 2016 to $434 million in 2025, while the number of recipients has grown to nearly 8,700.

Auditors identified several questionable billing practices, including providers billing for more than 24 hours of work in a day—with one claiming 47 hours—and 15 providers who appeared to be working other jobs while billing DHHS. Auditors also found providers could alter hours after they had been verified electronically, including one agency that added 434.5 billable hours in a single month. Foley also questioned four one-person agencies that may have structured themselves as agencies to receive higher reimbursement rates.

DHHS said it has already made changes to address some concerns, including a system update that rejects visits exceeding 24 hours, and said it will investigate other findings. Foley emphasized that stronger oversight will become increasingly important as Nebraska’s aging population increases demand for the program, while ensuring legitimate providers are fairly paid and taxpayer dollars are properly accounted for.

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