Audit Shows Questionable Payments at Health and Human Services

Seven identified areas of concern within DHHS with total questionable payments amounting to millions of dollars.

Free Through Recovery and Community Connect had $1.4 million in payments made without required provider engagement.

DHHS paid behavioral health providers even when required face-to-face engagement or contact attempts did not occur.

GAP payments were made without sufficient documentation; 95% of receipts lacked evidence of financial need and 92% lacked evidence that other resources were exhausted, creating risk of duplicate or improper reimbursements.

Child Care Workforce Benefit payments to ineligible employees; improper payments totaled an estimated $217,397 statewide; some employees did not meet the 25-hour weekly work requirement.

Background checks for in-home services not completed or initiated for many providers; projected error rate for missing background checks was 41% and processes were inconsistent across divisions.

Verification of Home Visits – 34% of visits lacked electronic proof; EVV data not consistently used to verify in-home services.

$4.7 million paid for software to track EVV; vendor data incorrect for 67% of claims; the data were not used to monitor claim accuracy.

Summer Food Assistance Program: 5,872 children who should have received food assistance did not; 1,610 ineligible children received it.

Develop and implement procedures to detect and prevent questionable payments, including enforcing required provider engagement standards for Free Through Recovery and Community Connect.

Standardize and strengthen DHHS processes for background checks on in-home service providers; ensure a consistent, agency-wide approach.

Improve EVV controls by ensuring electronic proof is captured for home visits and by using EVV data to monitor claim accuracy and reduce manual entry.

Tighten GAP payment controls by requiring documented financial need, proper tracking, timely receipts, and committee approvals where applicable to prevent improper reimbursements.

Review and correct payments under the Summer Food Assistance Program and other programs to ensure eligibility and prevent ineligible payments.

Implement ongoing monitoring and audit routines to detect and prevent improper payments and improve data quality across programs.