Tran v. State, 303 Neb. 1

Ann Tran, a Nebraska Medicaid personal assistance services (PAS) provider who spoke Vietnamese, contracted with DHHS and signed provider service agreements (SPAs) in 2015 and 2016.
DHHS audited Tran after a fraud referral and found timesheets showing overlapping billed hours between different Medicaid clients and missing supporting records; payments were suspended and Tran was asked to produce documentation and perform a self-audit.
Tran admitted she completed timesheets in advance, did not keep copies of weekly timesheets, and conceded occasional overlaps for emergencies; she also worked as an on-call substitute teacher for Lincoln Public Schools (LPS), which complicated payroll comparisons.
DHHS’s audit identified multiple overlapping client-service entries independent of Tran’s LPS work; Tran’s clients submitted affidavits supporting her that she provided authorized hours.
The DHHS Director terminated Tran’s Medicaid provider agreements for good cause (permanent exclusion) for overlapping services, failure to maintain and produce records, and breach of the SPA; the district court affirmed after de novo review, and the Nebraska Supreme Court affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether competent evidence supports finding Tran billed overlapping services between Medicaid clients	Tran: timesheets reflected actual hours provided; LPS payroll errors caused mischaracterization; no factual overlap	DHHS: audit and independent entries show multiple overlaps unrelated to LPS; Tran admitted estimating timesheets and failing to correct them	Held: competent evidence supports finding of overlapping billing and inaccurate timesheets
Whether DHHS’s permanent exclusion sanction was arbitrary or excessive	Tran: no intent to deceive, cooperated with audit, would comply going forward; lesser sanctions (education) appropriate	DHHS: breaches (false claims, failure to produce records, SPA violations) and extent of violations justified severe sanction; sanction selection is director’s discretion	Held: sanction not arbitrary or capricious; district court reasonably affirmed permanent exclusion

Leon V. v. Nebraska Dept. of Health & Human Servs., 302 Neb. 81 (applicable standard for APA review and agency deference)
Prokop v. Lower Loup NRD, 302 Neb. 10 (scope of district court de novo review of administrative orders)
Rainbolt v. State, 250 Neb. 567 (district court powers on administrative review)
Gridiron Mgmt. Group v. Travelers Indemnity Co., 286 Neb. 901 (presumption that agency action is correct; burden on challenger)