Mental Health Company With Weymouth Facility Sued By AG's Office

WEYMOUTH, MA – A company with mental health facilities across the state, including one in Weymouth, has been sued by the state's Attorney General.

Attorney General Maura Healey announced Tuesday that she is pursuing charges against South Bay Mental Health Center, Inc. (SBMHC) for fraudulently billing the state’s Medicaid Program, known as MassHealth, for mental health care services provided to patients by unlicensed, unqualified, and unsupervised staff members at clinics across the state.

“This company provided substandard care to many vulnerable patients and fraudulently billed the state for its inadequate services,” Healey said in a release. “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.”

SBMHC operates mental health facilities across the state including in Attleboro, Brockton, Cape Cod, Chelsea, Dorchester, Fall River, Lawrence, Leominster, Lowell, Lynn, Malden, Pittsfield, Plymouth, Salem, Springfield, Weymouth, and Worcester.

The AG's office alleges that BMHC had a widespread pattern of employing unlicensed, unqualified, and unsupervised staff at its mental health facilities in violation of MassHealth regulations. The complaint alleges that by submitting claims to MassHealth for mental health services provided by unlicensed and unsupervised personnel, the company submitted fraudulent claims in violation of the Massachusetts False Claims Act.

The 17 clinics named in the complaint featured significant gaps in licensing and supervision of therapists during the relevant time period. Many of the employees at SBMHC clinics who were performing mental health services did not have degrees in social work and instead had degrees in such areas as expressive therapy, art therapy, creative arts therapy, school counseling, somatic counseling, and agency counseling, the AG's office said.

From August 2009 to the present, MassHealth and its contracted managed care entities paid SBMHC more than $123 million for outpatient services including mental health counseling, such as psychiatric diagnostic evaluations and psychotherapy. 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.

Through this lawsuit, the AG’s Office is seeking treble damages, civil penalties, and prejudgment interest.

Information from the state Attorney General's office was used in this story.

Image via Shutterstock