Massachusetts False Claims Act lawsuit revealed that unqualified unsupervised South Bay employees provided “mental health treatment” to thousands of Massachusetts residents
BOSTON, MA. Mental health services provider South Bay Mental Health, Inc. and its parent companies Community Intervention Services, Inc. and Community Intervention Services Holdings, Inc. have agreed to pay $4 million to the Commonwealth of Massachusetts to settle the Commonwealth’s allegations that South Bay used unqualified, unsupervised mental health workers and unqualified Supervisors to treat its patients in Massachusetts, and they fraudulently billed MassHealth (Medicaid) and its payor contracted companies for these services.
The whistleblower who originally brought the action, Christine Martino-Fleming, is represented by Jeffrey A. Newman of Jeffrey Newman Law Boston and Marblehead and his co-counsel Waters & Kraus of Dallas, Texas. In the Complaint, Ms. Martino Fleming, a former Job Coach and later Coordinator of Staff Development and Training for South Bay, revealed detailed information alleging that South Bay was well aware of its wrongdoing. and that in fact it commissioned its own internal investigation through “Tiger Teams” which issued reports specifically concluding that South Bay’s Supervisors and Mental Health workers were not qualified in accordance with laws and regulations. In addition, in many cases, the Directors of the various South Bay clinics located in various parts of the state, themselves were not properly qualified and credentialed, according to the Complaint. When Ms. Fleming realized the extent of the wrongdoing, she sent several emails to her superiors notifying them of the problems but nothing was done. The Complaint alleges that the Defendants Scanlon, Sheehan and South Bay had specific knowledge of the ongoing fraud. The Complaint says that during the period 2009-2015 “South Bay allowed its unlicensed, inexperienced and unqualified counselors to treat patients with mental health issues without the supervision of qualified Supervisors, many of whom were unlicensed.” According to South Bay’s web site, over 35,000 individuals are treated each year.
Ms. Martino-Fleming, will receive $700,000 as her share of this portion of the case pursuant to the Massachusetts False Claims Act. This law, like the federal False Claims Act, allows individuals with information about fraud on the government to bring actions on behalf of the state or The United States of America. The laws allow the whistleblowers to recover up to 30% of what the governments recover.
In addition, as part of the settlement, South Bay must undergo an Internal Compliance Program for a period of five (5) years to ensure that it is in full compliance with all licensure and supervision requirements for mental health center staff. The release is appended.
The pending cases against H.I.G. Capital LLC, HIG Growth Partners, LLC, South Bay, CIS, CISH, Peter J. Scanlon and Kevin Sheehan, filed by Ms. Martino-Fleming’s Counsel on behalf of the United States of America, remain open and litigation will ensue in those actions which have not been settled.
Jeffrey Newman Law is a law firm dedicated to representing whistleblowers nationwide in False Claims Act (or “qui tam”) litigation involving fraud against the Federal and state governments. Founded by Jeffrey A. Newman Esq., the firm has a consistent track record of winning landmark, multi-million dollar settlements in cases involving Medicare, Medicaid, and healthcare fraud as well as other SEC and IRS whistleblower actions. In 2016 and 2017, the firm settled cases over $200 million. For more information, please visit www.jeffreynewmanlaw.com or contact Jeffrey Newman Law at 1-800-682-7157.