Mental health provider, Seasons of Hope, has had its provider status restored after a nine-day hearing over allegations of fraud.
The hearing officer in the case was Peter D. McDermott. He is a retired district judge from Pocatello. He most notably presided over the murder trials of Torey Adamcik and Brian Draper. McDermott issued his written ruling in this case on Tuesday.
In his ruling McDermott issued four items of judgment and order. They are:
1-The Department's allegations of fraud against Seasons of Hope are dismissed.
2-Seasons of Hope's allegations of fraud against the Department are dismissed.
3-The Department's suspension against Seasons of Hope is removed and Seasons of Hope's provider status restored.
4-The Department of Health and Welfare is entitled to a judgment and order for the following amounts: $94,161.40 in Recoupment, $9,986.84 in Civil Monetary Penalties, and $8,145.12 in Fines.
Seasons of Hope has 14 days to file an appeal.
The CEO for Seasons of Hope, Heath Sommer, Ph.D., issued statement to KPVI on Tuesday evening. It states:
"Having received the news of the vindication of my staff, my agency, and myself has been a blessing of great magnitude. Still we are trying to process how a branch of the government we all pay for chose to shut down a viable business rather than make a few simple, inquiring phone calls that could have saved so many jobs and continued needed services for hundreds of patients. But, this is America, and we have the gift of reopening our doors and starting over. Tomorrow we begin again."
This all began at the end of March when the Department of Health and Welfare sent a letter to Seasons of Hope alleging fraudulent practices such as billing for unprovided services and offering services that exceeded limitations. That letter suspended Seasons of Hope provider status and forced the company CEO, Dr. Heath Sommer, to lay off all of his employees, shut down his several offices and send all of his patients to other providers. The state was alleging fraud to the tune of over $400,000 in charges and penalties. From the beginning Sommer vigorously denied the charges of fraud.
In his written ruling, McDermott affirmed that the Department of Health and Welfare acted appropriately in suspending the provider status. But he also said that had Seasons of Hope been given a chance to respond to the allegations of fraud, the process of resolving the case could have been markedly different. By law, Health and Welfare was not required to give Seasons of Hope a chance to respond.
As for the penalties, McDermott found that most of the areas where Seasons of Hope had mistakes in billing were in two categories: Services Billed Without Valid Treatment Plans ($27,563.04) and Exceeded Service Limitations ($45,403.34).