NEWPORT — Northeast Kingdom Human Services has agreed to pay $65,335 and undertake organizational reforms to settle allegations that it neglected a vulnerable adult and overbilled Vermont Medicaid, Attorney General Charity Clark announced.
The state’s Medicaid Fraud and Residential Abuse Unit alleged that NKHS failed to adequately care for a client with severe developmental disabilities who posed a risk to themselves and others. Investigators said the agency failed to properly assess risks, create adequate care plans and take corrective action despite knowing the client was not being safely supervised in a shared living arrangement and was exhibiting escalating behaviors.
The settlement also resolves a separate billing issue that NKHS detected and self-reported. The agency incorrectly billed Medicaid for 149 psychotherapy appointments at the 60-minute session rate when shorter sessions had been provided, resulting in an overpayment of $8,425.73, according to the Attorney General’s Office. NKHS cooperated with the investigation.
Under the settlement, NKHS will improve its process for preparing behavioral support plans and other documents detailing behavioral interventions and required levels of supervision. The agency will also improve communication of those plans to caretakers and provide additional training for staff and supervisors. NKHS has agreed to hire a consultant to assist with preparing behavior support plans for individuals who pose a known risk to themselves or others.
“Vermont’s Medicaid providers must engage in robust compliance monitoring and promptly self-report errors,” Clark said.
