IHSS Fraud Prevention and Reporting 2 — Questions and Answers
Question 1: An IHSS provider signs timesheets for hours they did not actually work. This is best described as:
- A scheduling error
- Timesheet fraud (Correct answer)
- An overtime violation
- A payroll discrepancy
Correct answer: Timesheet fraud
Claiming payment for hours not worked is timesheet fraud, a serious IHSS program violation.
Question 2: Which of the following is a red flag that a recipient may be coercing their provider into committing fraud?
- The recipient calls to check on the provider's arrival time
- The recipient asks the provider to sign blank timesheets in advance (Correct answer)
- The recipient requests help with a new personal care task
- The recipient schedules services during daytime hours only
Correct answer: The recipient asks the provider to sign blank timesheets in advance
Asking a provider to sign blank timesheets allows the recipient to fill in unauthorized hours, a clear fraud indicator.
Question 3: What does 'double billing' mean in the context of IHSS fraud?
- Charging twice the approved hourly rate
- Billing for services that were provided by two different people
- Claiming payment for the same hours from multiple programs or payers (Correct answer)
- Submitting a timesheet twice by accident
Correct answer: Claiming payment for the same hours from multiple programs or payers
Double billing occurs when the same service hours are billed to more than one program, such as IHSS and Medi-Cal simultaneously.
Question 4: A provider is caring for an IHSS recipient but also watching their own children during those same hours. What is the main concern?
- Child labor law violations
- Billing for hours not fully devoted to the recipient, potentially constituting fraud (Correct answer)
- A violation of provider scheduling rules
- An insurance liability issue
Correct answer: Billing for hours not fully devoted to the recipient, potentially constituting fraud
Providers must dedicate authorized work hours entirely to the recipient; splitting attention with personal obligations can constitute fraudulent billing.
Question 5: Which agency is primarily responsible for investigating IHSS fraud allegations in California?
- The California Department of Motor Vehicles
- The California Department of Social Services (CDSS) (Correct answer)
- The Federal Bureau of Investigation (FBI)
- The Internal Revenue Service (IRS)
Correct answer: The California Department of Social Services (CDSS)
CDSS oversees the IHSS program and has authority to investigate fraud allegations, often in coordination with local counties.
Question 6: An IHSS provider realizes they accidentally submitted a timesheet with an extra hour included. The best course of action is to:
- Ignore it since the overpayment is small
- Contact the county IHSS office to correct the error immediately (Correct answer)
- Submit a larger timesheet next period to offset it
- Notify the recipient but take no other action
Correct answer: Contact the county IHSS office to correct the error immediately
Reporting and correcting accidental overpayments promptly demonstrates good faith and prevents unintentional fraud.
Question 7: Which of the following best describes 'ghost employee' fraud in IHSS?
- A provider who works the night shift
- A provider listed in records who does not actually perform services but still receives payment (Correct answer)
- A provider whose paperwork was lost by the county
- A recipient who moves without notifying their caseworker
Correct answer: A provider listed in records who does not actually perform services but still receives payment
A ghost employee is a fictitious or inactive provider who is paid without delivering real services, representing a form of IHSS fraud.
IHSS Fraud Prevention and Reporting 2
An IHSS provider signs timesheets for hours they did not actually work.
This is best described as: