Northeast Kingdom Human Services (NKHS) will pay Vermont $65,335 to resolve accusations of overbilling Medicaid and neglect of an adult with developmental disabilities in its care, the Attorney General's Office announced.
The settlement stems from an investigation by the Medicaid Fraud and Residential Abuse Unit. Between June 2022 and August 2024, NKHS failed to properly assess risks for a Medicaid patient with developmental disabilities living in a community arrangement the agency oversees. The patient was restrained and transported in an unsafe vehicle, and the agency ignored safety concerns despite knowing of escalating sexualized behavior. NKHS received $36,910 in Medicaid payments for that patient's care during that time.
Rebecca Silbernagel, spokesperson for the Department of Disabilities, Aging & Independent Living, said supervisors involved have been terminated. A consultant is reviewing behavior support plans for about 45 high-need individuals; about a quarter have been reviewed so far.
Separately, NKHS self-reported that a therapist billed for hourlong sessions that were shorter, overcharging Medicaid $8,425.73. The settlement covers both issues.
Attorney General Charity Clark said her office has investigated Medicaid fraud for decades and that federal scrutiny has not changed its mission. "We were doing this work long before President Trump came into office," she said.
NKHS also faces a separate lawsuit from a former employee alleging incorrect billing at its mental health urgent care. The Attorney General's Office said that case is unrelated to this settlement.
NEK will be looking into the details of the former employee's lawsuit and the consultant's final review findings.
Photo: Austin via Unsplash. Photo is illustrative and not from the scene.
Log in as a subscriber to comment, or become a member.