Mass. Alleges Massive Bogus Billing by Mental Health Clinics

A chain of mental health clinics in Massachusetts is facing a state attorney general lawsuit alleging massive Medicaid fraud.

At issue is $123 million in billings, a significant portion of which the state AG says was based on fraudulent claims for services rendered by unlicensed, unqualified, and unsupervised staff.

Medicaid, the federal-state health program for people with low incomes, pays claims for mental health services but only if they are provided by licensed or supervised counselors. South Bay Mental Health Center Inc., owned by Community Intervention Services Inc. and H.I.G. Capital LLC, had a “widespread pattern of employing unlicensed, unqualified ...