Auditors: Therapists paid hundreds of thousands for unverified work

Legislative auditors told lawmakers Friday the Division of Public and Behavioral Health paid psychiatrists and psychologists for hundreds of hours and thousands of dollars of work that wasn’t documented.

The audit report issued this week says $167,000 was improperly paid over several years to two psychiatrists who claimed on-call pay they weren’t eligible to receive because they’re employees.

One of them received on-call pay for 363 days in fiscal 2017.

The report also had sharp criticism for contractors who billed the division for hours worked without providing any proof those hours were actually worked. Of the 1,344 hours billed, more than half, 702 hours, were unsupported by documentation.

They pointed out that for just about half the payments to inpatient contractors, the bills reported “offsite work” with no further explanation of what work was performed. One Southern Nevada psychiatrist, they said, consistently billed two hours a day for offsite work but the computer system records showed after hours use of the system was just 19-24 minutes a day.

“So these contractors basically submitted a false billing,” said Assemblywoman Maggie Carlton, D-Las Vegas.

Auditors called for stronger oversight to clinicians both in state service and on contract including new policies to monitor hours worked by both contract and state workers and a system to approve offsite hours allowed for psychiatrists and psychologists.

They also urged the division to contact legal counsel about options for reimbursement for improper payments.

Auditors said the process of hiring contractors is also vague and the terms and requirements of those contracts aren’t well spelled out.

Deputy Auditor James Thorne told lawmakers to fix some of the issues involving contractors. All those proposed contracts must now go through the Board of Examiners which will permit legislative as well as the governor’s finance staff to examine them.

Auditors also found what they ruled “abuse of travel expenses” by a specific contractor they said “made increasingly extravagant travel arrangements by paying for airline travel packages at five-star hotels, luxury suites, airport and hotel valet parking.”

Director of Health and Human Services Richard Whitley told the panel his frustration is “every time we have an audit, how come I don’t know this.” He said he’s making corrective actions, changing policies and procedures to tighten controls over both state employees and contractors among the clinicians in HHS. He said they have more than 600 employees who are contractors, fully 10 percent of HHS staff.

“We’re trying to correct it and prevent it,” he said of the abuses.

Assembly Majority Leader Teresa Benitez Thompson, D-Reno, said she thinks it’s time the department and legislature looked at rethinking the extensive use of contractors, making more of them state workers.

But Whitley said they hire contractors because they can’t recruit doctors at current state pay levels.