FREQUENTLY ASKED QUESTIONS (FAQs)
Fraud is intentional deception or misrepresentation that an individual makes knowing it to be false, and may result in unauthorized benefit payments either to that individual or to some other person. It includes any act that constitutes fraud under any applicable federal or state law.
- Filing claims for services or items not furnished
- Tampering with prescriptions
- Using stolen Medicaid numbers
- Filing claims for visits never made
- Adding charges that don’t exist
- Selling supplies/equipment/medications
- Providing false information
- Medical records
- Claims
- Applications
- Identity of provider or patient
Abuse includes incidents or practices that are not consistent within accepted Medicaid or business standards, and may result in unnecessary costs to Medicaid. Abuse may evolve into fraud.
- Intentionally underreporting income, assets, resources etc.
- Residing out-of-state
- Drug seeking behaviors
- Over utilization of health care services
- Selling products, medications and/or supplies
- Provider billing irregularities
- Excessive charges for services or supplies
- Claims for services that are not medically necessary
- Improper billing practices by the provider
- Billing for services not provided
- Inaccurate coding
- Misrepresentation of professional credentials/licensing/status of licensure
How to Report Fraud, Waste, or Abuse
You can anonymously report suspected fraud, waste and abuse directly to the Director of Quality Assurance and Compliance (802) 952-6059
DVHA link for reporting fraud and abuse:
https://dvha.vermont.gov/providers/program-integrity/program-integrity-contact-information
How to Report Fraud, Waste, or Abuse
Testimonials
Loading...
-
I most enjoy spending time in the community and with [HCRS] staff.
DS service recipient -
My Service Coordinator makes me feel heard. They listen, understand, and show compassion.
DS service recipient -
I most like being able to go to work and have a job to support myself.
DS service recipient -
My son’s [HCRS] therapist meets with him at his school. She is amazing. She has developed a strong bond with him in a short amount of time. It is clear she is invested and wants him to succeed and feel good. We are very grateful for her.
Children’s service recipient -
Being able to have appointments through Zoom has been a huge help. It makes it easier to keep appointments, cuts down on stress as I don’t have to worry about transportation or if I can afford gas for my car. It also helps with anxiety when the weather is bad as I don’t have to drive. It is also really easy to get in contact with your team. Everyone is very reachable by either phone or email…I feel like I can reach out to either our case manager or counselor at any time, which helps with making me feel very supported.
CRT service recipient -
I most love that services are consistent and tailored to my daughter.
Children’s service recipient -
I most love that services are available both in-person or online.
Adult service recipient -
[HCRS] staff are kind and understanding.
Adult service recipient -
My son adores his provider and enjoys spending the time with her.
Children’s service recipient -
My case workers listen to me and understand that I know myself best and what works or doesn’t work for me.
CRT service recipient -
My counselor supports me in exploring successful approaches to dealing with my issues.
Adult service recipient -
I never feel like I’m being judged, so it’s easy to ask for whatever I need. In turn, staff have shown full and complete effort in finding the most effective ways to support my healing and growth.
Adult service recipient -
[HCRS] services have helped me feel more secure after being hospitalized for more than a year.
CRT service recipient -
I always feel welcomed and heard. Someone is always available in a time of need. It’s a no judgment zone.
Adult service recipient -
My counselor is very in tune to what I need.
Adult service recipient -
Everybody [at HCRS] works hard to help you.
Adult service recipient -
The online services option has worked best for me. My case worker is amazing, and I am glad for [HCRS] services.
Adult service recipient -
I feel like I can talk to my counselor about anything and everything openly.
Adult service recipient -
My case worker makes me feel like I’m a person.
Adult service recipient -
My suggestions are taken seriously. If I share ideas, HCRS will try to make it happen if they can.
CRT service recipient
