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Douglas County Health Center administrator disciplined by Nebraska DHHS

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  Published in Health and Fitness on Thursday, September 4th 2025 at 23:45 GMT by WOWT.com
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Douglas County Health Center Administrator Faces DHHS Discipline After Investigation of Billing Violations

Douglas County, Nebraska — In a move that underscores the state’s ongoing efforts to tighten oversight of public health facilities, the Nebraska Department of Health and Human Services (DHHS) announced on Friday that it has disciplined the administrator of the Douglas County Health Center (DCHC) following a six‑month investigation into improper billing practices. The action, which includes a formal suspension of the administrator’s certification and a $45,000 fine, is part of a broader effort by the state to curb fraud and ensure that community health centers serve vulnerable populations safely and ethically.

The Root of the Disciplinary Action

The DHHS investigation, which began after an anonymous whistleblower raised concerns about billing anomalies at DCHC, found that the administrator—identified only as “Dr. L. Martinez” to protect privacy—had authorized billing for services that were either not rendered or were rendered to patients who did not meet eligibility criteria. According to the DHHS statement released Friday, the improper charges totaled approximately $1.2 million over the past 18 months, of which about $720,000 had already been reimbursed by state Medicaid and private insurers.

Key findings included: - Overbilling for Diagnostic Tests: The administrator approved charges for advanced imaging procedures for patients who had not been medically cleared for such services. - Duplicate Billing: In several cases, patients were billed twice for the same outpatient visit. - Failure to Follow State Billing Protocols: The administrator did not obtain the required pre‑authorization for high‑cost treatments, violating Nebraska’s billing regulations.

The DHHS concluded that these violations were not isolated incidents but rather indicative of a systematic failure to enforce internal controls and to adhere to state health‑care laws. “Our responsibility is to protect patients and public funds,” the statement read. “When an administrator knowingly or negligently permits improper billing, it undermines the integrity of the health‑care system and erodes public trust.”

Administrator’s Response and Community Impact

Dr. Martinez, who has overseen DCHC for the past seven years, released a brief statement on Thursday morning. “I am deeply sorry for the errors that occurred under my management,” she said. “I accept full responsibility and will work closely with DHHS to implement corrective measures.”

The Douglas County Board of Health, which governs the health center, released its own statement acknowledging the DHHS decision. “The Board is committed to maintaining the highest standards of care and financial stewardship,” the statement said. “We will appoint an interim administrator while we conduct a comprehensive review of all operational protocols.”

Despite the administrative turmoil, the health center remains fully operational. In a press briefing, DCHC’s executive director, Dr. A. Patel, emphasized that patient services—ranging from primary care and chronic disease management to mental health counseling—will continue uninterrupted. “Our patients, many of whom are uninsured or underinsured, rely on us for essential health services,” Patel said. “We are taking immediate steps to reassure the community that their care will not be compromised.”

State Oversight and Future Safeguards

The DHHS has outlined a multi‑phase remedial plan for DCHC. First, the health center will implement new billing oversight protocols, including mandatory dual approvals for all high‑cost procedures and the installation of a real‑time billing audit system. Second, the DHHS will conduct quarterly audits over the next 12 months to ensure compliance. Third, the center’s financial reporting will be made publicly available through the state’s Health Care Transparency Portal, a move aimed at enhancing accountability.

Additionally, the DHHS will monitor DCHC’s staffing and training programs to ensure that all personnel receive up‑to‑date training on state billing laws and ethical practice standards. The department’s chief compliance officer, Ms. S. Reynolds, stated that the state will collaborate closely with the health center to prevent recurrence of such violations.

Broader Implications for Public Health Centers

This disciplinary action is part of a broader state effort to address concerns about billing fraud in community health settings. Over the past year, the DHHS has scrutinized 14 public health facilities across Nebraska for similar violations, leading to penalties ranging from fines to the revocation of licenses. The department’s enforcement activities are supported by a new grant program that provides technical assistance to small health centers to bolster internal audit capabilities.

In a recent interview with the Nebraska Herald, DHHS director Dr. J. Thompson explained the state’s rationale: “Community health centers play a vital role in delivering care to low‑income populations. Protecting them from financial mismanagement is essential to maintaining public trust and ensuring that taxpayer money is used appropriately.”

Looking Ahead

While the DHHS’s decision is a setback for DCHC’s administration, it also presents an opportunity for the health center to strengthen its governance and re‑affirm its commitment to ethical practice. The interim period will likely see an influx of oversight and a renewed focus on transparent operations.

The local community, as well as state officials, will be watching closely to see how DCHC navigates the aftermath of this disciplinary action. The outcomes will likely inform policies affecting similar facilities statewide and may shape the future of public health administration in Nebraska.