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Patient Brokering: How to Identify and Report Addiction Treatment Fraud

Date Published
Dec 07, 2022

Addiction treatment fraud is a betrayal of those who seek out care during some of the most difficult moments of their lives. Anyone battling addiction deserves respect and care, especially when they seek out treatment to break free from the cycle of addiction.

For these reasons, patient brokering is one of the worst kinds of addiction treatment fraud. A patient brokering scheme preys on people who need help, ensnaring them further into a web of dependency. Patient brokering may even incentivize the use of or provide access to more controlled substances in order to continue using people as pawns in financial schemes.

Speaking up about this vicious practice is a public service. If you have information about patient brokering or other kinds of addiction treatment fraud, coming forward is the right thing to do. You can save people battling addictions from harm, help reduce heartbreak amongst their families and friends and create a safer addiction treatment system for everyone. You can also reduce waste and taxpayer fraud while earning a substantial sum in the outcome of a successful case.

If you have any questions about becoming a whistleblower in cases of addiction fraud, do not wait. Contact the experienced law team of Tycko & Zavareei LLP for more information today.

What is Patient Brokering?

Patient brokering is an especially evil and unfortunately common kind of drug rehab fraud. The patient broker, or “body broker,” will receive kickbacks and financial incentives in order to refer people battling addictions to certain treatment programs or centers with which they share a financial relationship. Because of these financial motivations, it becomes imperative to keep people addicted, moving them from program to program, or keeping them on the hook in one program for longer than necessary.

Signs that you or your loved one may be involved in a patient brokering scam include:

  • Being offered a split, or cash payment, to enter into a rehabilitative program
  • Being offered airline vouchers, hotel rooms, or other incentives to enter into a rehabilitative program
  • Being given access to drugs or other substances between programs in order to continue to fuel the cycle

How Patient Brokers Manipulate Clients and Families

Rehab patient brokering can happen to anyone, and breaking out of the cycle can be just as difficult as breaking the addiction itself. Oftentimes, patient brokers may pose as friends or caretakers of those battling addiction, or they may loiter around sober living homes, detox centers, and AA or 12-step meetings with the intention of meeting people who may be vulnerable to their plans. In other instances, body brokers can be found at clubs or parties, offering access to substances in order to lure people into their system of commodification and control.

It is important to remember that many patients seeking to treat addiction and their families are new to treatment. Oftentimes, dealing with an addiction can leave someone and their family desperate, forcing them to rely on those who are more experienced in breaking the cycle. Unfortunately, this makes them targets of manipulation by brokers who pose as compassionate employees from treatment facilities.

If you are concerned or suspicious about the care you or a loved one is receiving from an addiction treatment center, speaking with an attorney is a viable option. Our expert team can offer insight into common addiction fraud schemes and help guide you through the process of reporting fraud to the authorities. Coming forward as a whistleblower is especially important if you are an employee of an addiction treatment center engaging in drug rehab fraud. Speaking up can help avoid implicating you in patient brokering schemes and will only aid the people who have turned to your center for care.

Common Types of Addiction Treatment Fraud

The following are a few common types of addiction treatment fraud:

  • Misrepresentation of Services: Overpromising results or offering programs or treatments that are not available are all too common in addiction treatment centers, especially those that are understaffed or overbooked.
  • Lead Selling: Selling or offering kickbacks for “leads,” or new patients, is often the first step in patient brokering.
  • Lead Buying: Illegitimate facilities may offer up financial rewards or payments for new patient referrals.
  • Patient Incentives: Body brokers may offer to share part of their profits with patients in order to entice them to enter certain facilities where they will not receive the care they need.
  • Billing for Unnecessary Services: The cost of many unnecessary or even harmful services is passed on to the taxpayer through Medicare/Medicaid funding. Facilities will bill for services that continue to keep patients addicted so that they can continue to profit.
  • Privacy Violations: Seeking treatment never means you forfeit your right to privacy. Addiction treatment is a medical concern and should be treated as such.
  • Insurance Fraud: Insurance fraud with publicly funded programs such as Medicare and Medicaid can be reported to the Department of Justice via a qualified fraud attorney. Becoming a whistleblower can help launch an investigation and prevent future instances of addiction treatment fraud.
  • Google Listing Theft: Identity fraud schemes like Google listing theft may misrepresent the legitimacy of treatment centers and so-called medical professionals in order to continue to run patient brokering scams.

How to Identify and Avoid Patient Brokering

Patient brokering laws and the federal Sober Home Task Force are in place to help prevent the commodification of those suffering from addiction. However, these enforcement actions often depend on the honesty and forthrightness of whistleblowers. The following are some ways to address patient brokering at the source if you or someone you love is about to enter into a treatment program:

  • Ask for a tour of the facility: Seeing a treatment facility in person, if possible, can help confirm or deny your suspicions.
  • Confirm state licensing: Legitimate addiction treatment centers will often offer consultations with licensed therapists. State licensing is imperative to ensuring that those who treat patients are professional and fully qualified.
  • Research staff and treatment methods: Recent cases have begun to unearth several large-scale addiction treatment fraud schemes run by a few different companies. 345 defendants, including over 100 doctors and nurses, were recently charged in the largest ever healthcare fraud and opioid enforcement action by the Department of Justice. Check to make sure the owners and operators of the treatment center you are entering are not on the list.
  • Check the Joint Commission: Joint Commission accreditation can help provide some peace of mind about the program you or a loved one is considering entering.
  • Inquire about services and programs offered: Ask about the kinds of services or programs offered to decide for yourself if they will serve your purposes.
  • Ask about treatment statistics: Treatment statistics, when available, can help provide information about a facility’s intended path to success.
  • Check SAMSHA: The Substance Abuse and Mental Health Services Administration offers a registry of ways to find treatment. Checking their website can help ensure the treatment center you are entering is legitimate.

What is Florida’s Patient Brokering Act?

The Florida rehab shuffle, or Florida shuffle, as it was named by the state attorney, was a particularly large-scale addiction treatment center fraud ring that led to a 2021 federal jury conviction for the two Miami brothers behind it. Their business, Second Chance Detox LLC, also known as Compass Detox, offered kickbacks to body brokers on the prowl for vulnerable patients. Body brokers provided illegal drugs in order to create patients eligible for rehabilitation. They also offered those with addictions plane tickets, hotel rooms, and cash. Once patients had been enlisted into the centers, they received “Comfort Drinks” laced to sedate them as well as continued access to controlled substances. Meanwhile, the illicit treatment center continued to bill for services, such as therapy or urine analysis, that were not provided or necessary to patients.

The Florida shuffle, one of the largest sober home task force arrests to date, was a scam that siphoned off $112 million from taxpayer funds while enabling a cycle of addiction and body brokering. It was also part of an $875 million discovery by the Department of Justice as part of their sober homes task force that helped reveal rampant addiction center treatment fraud.

The Florida rehab shuffle also helped lead to the creation of the Patient Brokering Act, a Florida statute similar to others across the nation that explicitly makes it illegal to offer, pay, or solicit a commission for referrals to any healthcare provider or facility.

How to Report Addiction Treatment Fraud

Reporting addiction treatment fraud is imperative. The sooner you speak up, the sooner it can be shut down. Ongoing scams like the Florida shuffle reveal the importance of blowing the whistle on drug rehab fraud. Do not allow bad actors to line their own pockets at the expense of taxpayers and vulnerable patients. To report addiction treatment fraud, the first step is to talk to a fraud attorney. They will become your liaison with the Department of Justice, coordinating any enforcement actions while protecting your privacy as much as possible. A lawyer can also protect your rights and privileges as a whistleblower, ensuring your employment is protected and your financial reward is as high as possible.

Talk to an Addiction Treatment Fraud Lawyer

To speak to an addiction treatment fraud attorney, reach out to Tycko & Zavareei LLP today via our complimentary online consultation form. Our attorneys can help assess whether or not you have a viable case and what steps will be necessary to take next. Collecting evidence is key, but only some materials are admissible in the qui tam court system. A legal professional can help ensure you are doing the right thing in the right ways to best protect your own interests.

Benefits of Filing a Qui Tam Lawsuit

Both federal and state laws incentivize and protect those who come forward as a whistleblower. Retaliation against whistleblowers is prohibited by several statutes. Employment protections for whistleblowers include:

  • Reinstatement at previous seniority level in the event of termination
  • Backpay
  • Legal fees
  • Freedom from harassment, discrimination, demotion, or reduced pay or hours as a result of blowing the whistle

In addition, whistleblowers can be eligible for 15 to 30 percent of the government’s total recoupment in the event of a successful case. In ongoing instances of drug rehab fraud, this amount may number into the thousands or even millions. Whistleblowers can walk away with a significant financial sum, as well as the satisfaction of knowing that they have done the right thing. Blowing the whistle protects the rights of patients and taxpayers alike.

Ask our Attorneys about Patient Brokering and How to Identify and Report Addiction Treatment Fraud

If you have information that may lead to a successful sober home enforcement action or help stop addiction treatment fraud, contact Tycko & Zavareei LLP as soon as possible. We are available to answer any questions you may have and can help you take the steps necessary to do the right thing. Coming forward can help break the cycle of patient brokering and make the addiction treatment system safer for everyone. Help patients work toward recovery, and not relapse, by speaking up about patient brokering and addiction treatment fraud today.

How can we help you?

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Our experienced qui tam attorneys are available for a confidential, no-cost, no-commitment, initial evaluation of your case. Call us now at (202) 973-0900, or begin the process by completing our Confidential Case Evaluation Form.
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