A Burlington-based mental healthcare provider, Revolution Youth, will pay the state $200,000 to settle Medicaid fraud allegations brought by the Vermont Attorney General’s Office.
As part of the civil settlement, the nonprofit outpatient practice — which operates as Eden Valley — has admitted to submitting hundreds of improper claims to the state’s Medicaid program between 2022 and 2024.
Its clinical director, Savannah Lord, backdated records, inflated billing hours, and submitted claims that did not meet the state’s minimum treatment and documentation standards, according to the agreement signed with the state.
“Medicaid dollars are limited and they are critical, so making sure that providers are delivering services appropriately is of the utmost importance,” Attorney General Charity Clark said Monday.
According to the settlement, the mental health agency submitted claims for services that weren’t considered medically necessary, including instances in which “there was no valid treatment plan.” Revolution Youth also billed for services provided by non-licensed therapists that didn’t meet the conditions for supervised billing under a fully-licensed practitioner.
“In some cases, Revolution Youth fabricated entire records,” the settlement says.
Lord was recently in the public eye for leading a successful pressure campaign against Blue Cross Blue Shield of Vermont, which was seeking to lower its reimbursement rates for non-licensed therapists. She referred a request for comment to Revolution Youth’s attorney, Kevin Henry, who wrote that the mental health agency had agreed to the settlement “to avoid the delay and expense of litigation and to keep its focus on providing care.”
“Revolution is confident that its clinicians provided care to clients with professionalism and will continue serving clients while protecting patient privacy,” Henry added. “Because this settlement involves Medicaid compliance and protected health information, we can’t discuss client details or personnel matters beyond what’s in the public agreement.”
Henry said Revolution has already begun implementing stronger documentation and billing controls, and is working on a formal compliance report it’s required to submit to the state’s Medicaid office.
Revolution Youth’s settlement payment is split between $150,000 in restitution and $50,000 in penalties.
