Updated March 6 at 4:05 p.m.
Vermont is the target of the latest federal probe into Medicaid fraud, waste and abuse.
State officials received a letter Tuesday from representatives on the U.S. House Committee on Energy and Commerce requesting information on the state’s Medicaid program. The committee sent nine other states — almost all of which are Democratic-led, including Maine and Massachusetts — similar requests for information.
The letter cites the federal investigation into Minnesota’s Medicaid program surrounding suspected fraud, waste and abuse in how health care providers bill the health coverage program for those with low incomes.
“The Committee is concerned that your state’s Medicaid programs may be similarly vulnerable to (fraud, waste and abuse) that harms Medicaid enrollees, legitimate providers, and taxpayers,” the letter reads.
Jill Mazza Olson, the Medicaid director for Vermont’s Agency of Human Services, said the state was not necessarily expecting this letter to come from the congressional committee, but has had a “heightened awareness” around waste, fraud and abuse in Medicaid surrounding the national attention.
“It’s something we take really seriously in Vermont,” she said. “We really try to watch the national landscape.”
Vermont has long been reliant on federal dollars in the federal-state partnership program. In 2024, the program spent $2.3 billion, $1.45 billion of which was drawn from the feds. More than 156,900 Vermonters rely on the program, the letter cites.
In January, the Department of Vermont Health Access, which administers Vermont Medicaid, requested a $33 million budget adjustment from the federal government to cover this year’s Medicaid costs.
Federal dollars, which are matched to state spending, are “critical” to Vermont, Olson said.
The congressional letter, signed by the committee’s Republican majority leaders, says that Vermont’s reliance on Medicaid makes it “high risk” for fraud, waste and abuse.
The authors go on to cite a number of cases of such errors that the state attorney general’s Medicaid Fraud and Residential Abuse Unit has pursued. That included a $200,000 settlement the Burlington mental health care provider Eden Valley had to pay for submitting more than 150 false records on 50 Medicaid claims.
Another example detailed the felony Medicaid fraud charges the Vermont Attorney General’s Office brought against a Lamoille County couple for submitting thousands of dollars worth of false timesheets for caretaking by an unauthorized provider.
“I think I would be concerned about a state that didn’t have any cases of fraud. That would suggest to me that they weren’t looking,” Olson said. “These are examples of cases of fraud that as a state, we have found and identified, and that’s the purpose of the systems that we have in place.”
The letter’s authors write that mental health care and personal care services, which allow Medicaid patients to get support in their own homes or communities, are particularly susceptible to Medicaid fraud.
They single out Applied Behavioral Analysis (ABA) therapy for those with autism. At the end of 2025, Vermont Medicaid implemented a controversial change to how it bills for ABA therapy, citing these concerns of fraud, waste and abuse. At the time, the state program expressed a desire to be “proactive” against scrutiny from the federal government that could more deeply jeopardize Medicaid services.
The congressional committee requested the state Agency of Human Services provide it with further information about how Vermont investigates and protects against Medicaid fraud.
In a statement, the agency said it is currently working with the Department of Vermont Health Access on its response to comply with the committee’s March 17 deadline.
“Vermont takes program integrity seriously and maintains safeguards to ensure Medicaid resources are used appropriately,” the agency’s spokesperson, Ted Fisher, wrote in a statement. “Vermont’s program integrity teams work closely with the Attorney General’s Medicaid Fraud and Residential Abuse Unit to investigate and address suspected fraud.”
Correction: This article has been updated to accurately reflect the Medicaid services the authors identified as higher risk for fraud.
