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.