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Vermont

Vermont mental health agency to pay $391,816 to settle Medicaid fraud allegations

The Vermont Attorney General's Office said Health Care & Rehabilitation Services of Southeastern Vermont kept Medicaid money it should have returned to the state, and has agreed to repay it and adopt new compliance measures.

A southeastern Vermont mental health agency will pay the state $391,816 to settle allegations that it improperly held on to Vermont Medicaid money it was supposed to return, the Vermont Attorney General's Office said Wednesday.

The settlement with Health Care & Rehabilitation Services of Southeastern Vermont, known as HCRS, resolves an investigation by the attorney general's Medicaid Fraud and Residential Abuse Unit. Along with the payment, the agreement requires HCRS to take specific steps to tighten its compliance practices, prosecutors said.

The investigation began after a referral from the Vermont Department of Aging and Independent Living, according to the attorney general's office. Investigators found that over a three-year period HCRS misused and kept Medicaid funds that should have gone back to the state, including money that was not spent for the purpose it had been budgeted for and, in some cases, money tied to clients who had already ended their services, the office said.

Unused money was supposed to be returned to the state's Equity/Public Safety fund so it could be redirected to other Medicaid recipients, prosecutors said.

The office also said investigators found that HCRS repeatedly made significant changes to a client's budget or services without adequately documenting that the services were medically necessary, and failed to send required notices to numerous clients when benefits were denied or suspended.

The allegations were resolved by agreement and were not tested in court.

This brief was drafted by AI from a public agency press release and published by The New England Signal. Why we use AI for stories like this one.

Vermont