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Clinic is among 17 facilties that allegedly provided services to patients by unlicensed staff
Weymouth News - 1/17/2018
Weymouth Mental Health Clinic is among 17 mental health clinics operated by South Bay Mental Health Center that allegedly provided mental health care services to patients by unlicensed, unqualified and unsupervised staff members, according to a lawsuit filed by State Attorney General Maura Healey.
"This company provided substandard care to many vulnerable patients and fraudulently billed the state for its inadequate services," said Healey in a written summary. "MassHealth members deserve competent treatment from qualified individuals, and our office will continue to take action in order to remove these significant barriers to accessing critical mental health care in our state."
Healey spokeswoman Emalie Gainey said the regional health director and health director at Weymouth Mental Health Clinic were not licensed for their positions under state law and during their employment with South Bay Mental Health.
"There were only four independently licensed supervisors at the Weymouth clinic," she said in a summary. "The majority of staff therapists at the Weymouth clinic were unlicensed and could not have been adequately supervised as required "
Gainey said Weymouth Mental Health Clinic, located in suite 303 at 541 Main St., was billing MassHealth for services by unlicensed clinicians who were not being appropriately supervised and while the clinic was operating with an unqualified clinic director.
"The director was in violation of the staffing and supervision regulations set forth herein, so call claims submitted to MassHealth whether through FFS (Fees For Service) MBHP (Massachusetts Behavioral Health Partnership) by the Weymouth Clinic were false and fraudulent," she said.
South Bay Mental Health Services which is based in Brockton operates facilities in Brockton, Attleboro, Cape Cod, Chelsea, Dorchester, Fall River, Lawrence, Leominister, Lowell, Lynn, Malden, Pittsfield, Plymouth, Salem, Springfield, and Worcester in addition to Weymouth.
Healey alleges all of the clinics named in her complaint had significant gaps in licensing and supervision of therapists from August 2009 until the present.
"The AG's investigation into these allegations began after a whistleblower lawsuit was filed by a former South Bay Mental Health Center employee in August 2015 in U.S.District Court.." stated a summary provided by Healey's office.
Healey's complaint alleges that insurance claims submitted by unlicensed, unqualified and unsupervised South Bay Mental Health Center staff to MassHealth for services provided violated the Massachusetts False Claims Act.
The complaint filed by Healy names South Bay Mental Health Center and Peter J. Scanlon who founded and owned the company until April 2012.
The complaint also names H.I.G. Growth Partners LLC and H.I.G. Capital LLC which created Community Intervention Services to acquire South Bay Mental Health Center from Scanlon as well as co-founder and Kevin P. Sheehan, CEO and co-founder of Community Intervention Services.
"From August 2009 to the present, MassHealth and its contracted managed care entities paid South Bay Mental Health Center more than $123 million for outpatient services including mental health counseling such as psychiatric diagnostic evaluations and psychotherapy," stated Healey's summary. "The AG's office estimates that a significant portion of that $123 million was based on fraudulent claims for services rendered by unlicensed, unqualified and unsupervised staff to more than 30,000 MassHealth members."
Healey is seeking treble damages, civil penalties and prejudgment interest, according to her summary.
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