A former employee of Northeast Kingdom Human Services has filed a civil lawsuit alleging the agency engaged in a fraudulent billing scheme that improperly double-billed Medicaid for mental health services.
Tesla Hubbard, hired in May 2024 as an emergency services clinician and later promoted to manage the agency's mental health urgent care, says she lost her job after raising concerns both internally and with state officials. The suit was filed March 11 in Vermont Superior Court.
According to the complaint, NKHS billed Medicaid twice for the same patient encounters: once under the fee-for-service mobile crisis program and again through a bundled monthly payment meant to cover all care for certain clients. The state Department of Mental Health had reportedly directed NKHS not to bill both ways for the same episode, the suit alleges.
The lawsuit identifies 59 services that were supposedly billed at the mobile crisis rate despite taking place at the agency's walk-in urgent care center, the Front Porch, which opened overnight beds recently after renovations.
Nicole Junas, a spokesperson for NKHS, said in a statement: "NKHS is aware of the complaint and takes the allegations seriously. We have been proactive in our engagement with the appropriate oversight agencies and are working with legal counsel." She declined further comment due to active litigation.
The suit also alleges gender-based discrimination, describing sexist remarks a supervisor allegedly directed at Hubbard. Her attorneys argue she is protected under Vermont's health care whistleblower law.
The case comes as federal lawmakers have launched a broader investigation into Medicaid fraud in Vermont and other states. Amelia Vath of the state Attorney General's Office neither confirmed nor denied an investigation, but Hubbard's attorney, Al Dean, said he believes the Department of Mental Health is looking into the matter.
Dean said the suit aims to protect both Medicaid beneficiaries and taxpayers, noting that mental health services in Vermont are "woefully underfunded and unavailable for people who are in need."
NEK will be looking into the status of any state or federal investigation into NKHS billing practices.
Originally reported by VTDigger.
Photo: Famartin (Wikimedia Commons, CC BY-SA 4.0). Photo is illustrative and not from the scene.
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