Addiction treatment center fraud is a particularly heartbreaking area of medical fraud. It both targets and takes its toll on those suffering from one of the hardest human experiences: addiction. It can set people back years in recovery, shatter lives and families, and fail those who need a lifeline the most. In its darkest forms, addiction treatment center fraud may not only provide inadequate care to patients, but it may also take the form of actually providing substances to those struggling with addiction in order to continue to profit off of them in a cycle of abuse.
If you or a loved one is battling addiction and has entered a treatment center where all does not seem to be as it should, contact an addiction treatment center fraud lawyer as soon as possible. There is help available, and reporting these kinds of predatory practices can also prevent harm from being done to other people who may be struggling. The law offices of Tycko & Zavareei LLP are experienced with all kinds of healthcare fraud and other government-funded program fraud. We are available to answer any questions you might have.
Patient Brokering: One of the Worst Kinds of Addiction Treatment Center Fraud
When you or a loved one are suffering from addiction and someone reaches out to get you into a treatment center, you might feel relief knowing that help is available. Unfortunately, patient brokering is one of the worst kinds of addiction treatment center fraud. This predatory practice involves giving or receiving kickbacks in exchange for referring patients to addiction treatment centers.
Patient brokers, or “body brokers,” receive fees that sometimes range into the thousands of dollars per patient that they refer to an addiction treatment center with which they share a financial relationship. These facilities may or may not be legitimate and often offer subpar care. Patient brokers may offer to share the fee they receive with the person who they are referring, or even give access to more substances in exchange for time spent in the program in order to keep patients addicted and in need of care.
Common warning signs of patient brokering may involve someone offering cash, plane tickets, hotel stays, or other incentives to move someone from treatment to treatment. Brokers may target clubs and parties, as well as AA meetings or rehabilitation centers to look for people who may be likely targets for this kind of predatory scam. Some patient brokers even go so far as to offer illegal drugs to create more commodities in their system.
Patient brokering victimizes those who need help battling addiction and commodifies patients. One of the reasons why patient brokering is so detestable is that relapse, instead of recovery, is built into the financial scheme at its core. Never forget that it is in brokers’ and illicit centers’ best interests for their patients to fail in order to continue to profit off of referrals and future kickbacks.
Common Forms of Addiction Treatment Center Fraud
Patient brokers are not the only ones who perpetuate addiction treatment center fraud. Shady institutions may engage in illicit or illegal practices that neglect patients and harm taxpayers, all while lining their own pockets. Common forms of addiction treatment center fraud include:
- Billing Medicare, Medicaid, and other government-funded health insurance programs for services that were never provided
- Accepting and billing for extra patients once a facility is over capacity
- Failing to provide adequate care
- Offering ineffective or unnecessary services
- Offering kickbacks for patient referrals
Addiction treatment center fraud is particularly harmful because those battling addiction can remain profitable as long as they are tied to substances. A center that aims to keep patients sedated and dependent can claim more payments for longer for those under their care. Unethical providers lose out on income once their patients are able to leave the center and stand on their own two feet against addiction.
Fraudulent Claims Involving the Opioid Crisis and Addiction Treatment Centers
The opioid crisis in America has been affiliated with many different kinds of fraudulent claims and schemes meant to profit off of addiction. In one of the largest enforcement actions ever recorded, the Department of Justice recently charged 345 defendants in 51 federal districts. Those charged with fraud and false claims involving addiction treatment centers involved over 100 doctors, nurses, and other medical professionals.
Some of the fraudulent claims for addiction treatment involved:
- $4.5 billion allegedly submitted in telehealth fraud schemes purportedly to treat addiction. Telehealth fraud has been a growing area of false claims since the COVID-19 outbreak.
- A so-called “Sober Homes” fraud scheme that charged owners and operators of ineffective addiction treatment centers with submitting false insurance claims, as well as medical professionals who prescribed medically unnecessary controlled substances and medications to entice patients to continue to stay.
- Illegal prescription or distribution of opioids, using fraudulent Medicare/Medicaid billing practices
Notable Cases Involving Addiction Treatment Centers
Qualified, experienced legal professionals like the team at Tycko & Zavareei LLP can be a powerful line of defense against addiction treatment center fraud. An addiction center treatment fraud attorney can help build a case with the Department of Justice and ensure that a whistleblower’s rights and privileges are protected. For instance, in many cases involving false and fraudulent insurance claims backed by government funds (such as Medicare/Medicaid fraud), a whistleblower is entitled to 15 to 30 percent of the government’s total recoupment. This means that blowing the whistle on addiction treatment center fraud can not only help protect the vulnerable, but can also reduce the waste of taxpayer funds, penalize unethical providers, and help reward those who come forward with the truth.
Some recent notable cases involving addiction treatment center false claims include:
- The conviction of two South Florida brothers by a federal jury as part of the Department of Justice’s Sober Homes initiative. The brothers were charged with operating homes that fraudulently billed services that were never provided to patients seeking treatment for addiction or which were medically unnecessary. This ongoing scam leeched approximately $112 million from public funds. Additionally, patients were found to be enticed by illegal drugs, cash, and plane tickets in order to enter into a cycle of abuse. Kept docile by “Comfort Drinks” provided at the facility and other illegal substances, the Miami brothers’ scam preyed on patients in what the state attorney called the “Florida shuffle.”
- CRC Health Group, a national chain provider of substance abuse treatment services, was ordered to pay $9.25 million to the United States government and the State of Tennessee for submitting false claims to the state’s Medicaid program. Treatment centers operated by the group were over capacity and continued to bill government funds, provided substandard care, and offered consultations with unlicensed therapists. The case was launched by a disclosure from a former employee who worked in the billing department for the health group. She will receive $1.5 million as her share in the qui tam case for blowing the whistle.
- In one Southern California case, patient brokers treated vulnerable patients as commodities for different treatment services. Facilities charged paid anywhere from $500,000 to $2.7 million to recruiters in exchange for patient referrals. This extensive kickback scam was addressed under both state and federal qui tam law, as California has a specific California Insurance Fraud Prevention Act.
What Can Be Done: Speak to an Addiction Center Treatment Fraud Attorney Today
If you know of an addiction treatment center scam, speak to an attorney today about what can be done. If you have information that can lead to a successful case, you may be able to receive a significant financial award. You may also be able to help shut down predatory treatment centers and practices, stop the commodification of vulnerable people, and help chip away at the addiction crisis facing America today.
Your call is confidential to Tycko & Zavareei LLP. Speak to our team by phone or via our online consultation form for a free evaluation of your case. Reporting is the right thing to do.