Letter: Fix the system

Nebraska's Medicaid Aged and Disabled Waiver helps older adults and people with disabilities remain safely in their homes and communities. The Nebraska Auditor of Public Accounts' recent report (Journal Star, Aug. 25) identifies serious concerns involving billing, documentation, eligibility and provider practices. These problems deserve attention. But providers who follow the rules should not pay the price for those who do not. Reputable providers train caregivers, document services, follow authorizations, use electronic visit verification and maintain strong internal controls. We support accountability and agree that services must be provided as authorized, accurately billed and consistent with each individual's assessed needs. We also believe caregiver rates should be reasonable, standardized and based on the individual's needs — not individually negotiated. The audit tested 47 participants selected based on risk factors; its findings do not demonstrate that these practices represent the majority of Nebraska providers. Nebraska should target fraud — not create more rules for everyone. The auditor's data demonstrates why funding must follow need. Of 7,316 participants, only 125 — 1.7% — received more than $200,000, yet they accounted for approximately $30 million in payments. People have vastly different levels of need, and funding should reflect those differences. Nebraska can protect taxpayer dollars while supporting quality care. Find the bad actors. Stop the fraud. Fix the system. Then let responsible providers continue helping Nebraska's older adults and people with disabilities live safely, independently and with dignity in their communities. Kierstin Reed, Lincoln Get opinion pieces, letters and editorials sent directly to your inbox weekly!