Are you a therapist, counselor or clinic employee who saw your employer bill the government for care that wasn’t provided, or wasn’t properly supervised?
Mental health clinics bill Medicaid and Medicare for therapy and medication visits. When bills are for services that were not performed, or were delivered by unlicensed or unsupervised staff, they can violate the False Claims Act. Employees who report it can bring a case and receive a share of the recovery.
CASE EXAMPLE: SOUTH BAY MENTAL HEALTH AND H.I.G., $29 MILLION
Christine Martino-Fleming, a licensed mental health counselor at South Bay Mental Health Center who also oversaw employee training, reported that South Bay and its private equity owner, H.I.G., caused fraudulent bills to be sent to MassHealth (the Massachusetts Medicaid program) for services by therapists who were not licensed or not properly supervised. H.I.G. and two executives agreed to pay $25 million, and South Bay paid $4 million earlier, for $29 million in total. The whistleblower award in the H.I.G. settlement was $6.75 million. Jeff Newman Law represented Ms. Martino-Fleming.
CASE EXAMPLE: NOVA PSYCHIATRIC SERVICES, $1.4 MILLION (MAY 2026)
Two employees, Jessica Spissinger and Matthew Peculis, reported that Nova and Patriot Eldercare billed Medicare, Medicaid and the state employee insurance program for psychotherapy and medication management that clinicians did not perform. The defendants agreed to pay $1.4 million, and the whistleblowers share 17.5% of it. The companies admitted certain facts.
Q&A
What are my options if I raised concerns internally and they went unaddressed? Employees in the Nova case did the same. Call us before you take another step at work.
What protections will I have from retaliation? Federal law prohibits retaliation for reporting fraud.
How are legal fees structured? There is no fee unless we win.
Call 617-823-3217 for a free, confidential consultation.
