Home » The high cost of insurance fraud in drug rehab

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The high cost of insurance fraud in drug rehab — 14 Comments

  1. This is why mental health was excluded from health insurance until the Socialists got hold of it. Years ago I was on a committee that reviewed mental health referrals for military dependents who had Champus. They were larded with fraud. Parents with unruly teenagers would get them sent back to San Diego from Guam for inpatient treatment. It was just a way to get rid of them at government expense which was enormous.

  2. I am not surprised at the fraud, but am at the gargantuan scope. My clue was simply the large amount of expensive advertising I see on mainstream TV offering drug treatment AND my skepticism that any treatment programs yet developed are that effective. I imagine that those drug users who are enticed into the program are not yet ready (if they ever will be) to change.

  3. One more example of a society devolving into ever deepening levels of corruption.

    Here in FL, the local news regularly features stories on restaurants that have failed multiple health inspections, some with a number of serious violations, yet remain open for business. Graft and corruption, extending into the legislature and executive branch, must be a factor in why state health inspectors haven’t closed them down…

    It’s also noteworthy that the news never explores or follows up as to why this state of affairs exists.

    When state officials turn a blind eye to serious health and basic hygiene violations in food service businesses, why would they be concerned with graft and corruption in rehabilitation programs for drug users?

    John Adams had the right of it; the elected representatives in a republic will reflect the moral and religious character of the society from which they are selected.

    This is why we have many more Chuck Schumers than Tom Cottons.

  4. South Florida in particular has been a star in the health-care fraud arena, for decades.
    Data that I recall from the 1980s showed median costs of having a stroke in Miami were double what they were in other Gulf South areas.

    Young adults are particularly vulnerable to addiction, be it tobacco or alcohol or opioids. Has something to do with brain maturity.

    It is clear that AA is the best program for alcoholism, costs nothing, as long as the alcoholic is willing to do what it takes. I’m not sure of the Narcotics Anonymous data but its principles are the same.

    The failure, as shown in this article, is by multiple actors: 1) the Bleeding Heart State 2) the failure of the Federal State to interdict drug cartel deliveries-see Obama and Holder on that. Most Fentanyl is made in China, our good trading buddy. China has a vile record on many drug fronts- see the history of heparin. 3) Insurance coverage, plus the 26 year-old coverage deal- more Obama 4)Societal- Libertarians and others consider these events victimless crimes and oppose drug laws 5) The massive #s of drug dealers pardoned from Federal prisons by Obama-
    what will they do but return to dealing? 6) More Societal: Passivity of parents, “too busy”, as Allison’s mother claimed to be, shoving unopened insurance coverage statements into a drawer, ‘estimating’ that $750K was spent on Allison. 7) Individual: Allison herself; what she did was voluntary.

    Acute withdrawal from alcohol causes the DTs, which can be fatal if not adequately treated. Withdrawal from opioids without legal narcotic coverage like Methadone causes several days of restlessness, irritability, other discomforts, but not cognitive impairment, seizures, aspiration and death.

    Of course there is huge fraud in treatment (ahem) centers, which are boarding houses with a few “counselors” that require 30, 60 or 90 day stays. Drugs and booze are smuggled in. They are a gold mine for the unethical. The “halfway houses” for those released from the centers are self-policing and also profit-driven, and we know how well that works. So be not surprised.
    This is not going to get fixed anytime soon. In the meantime, we’ll just blame the convenient scapegoats, physicians prescribing opioids for patients in need whose relatives steal and use/sell the drugs.
    I prescribed a lot of Fentanyl patches for cancer pain; it was great for patients. But illegal Fentanyl is made in pill form, with uncertain amounts of drug…so, overdoses.

  5. OT: A post of yours entitled Starting to Leave the Left appears in my newsfeed but when I click the link I get Page Not Found.

  6. “And why on earth was a new license given by the state of Florida? Was someone on the take?”

    The second question answers the first.

  7. At my brother’s highly regarded, state subsidized, half-way house the mortality rate was only 60% after two-years.

    That figure is low since it does not adjust for the most recent arrivals.

    Booze, meth or morphine, the boyz just could not stop reverting to habit.

    That’s the nature of intense addiction.

  8. The more obscure regulatory bodies have more influence than we generally see.
    Still, it’s there, in the licensing and permits and inspections.
    The question about “take” is obvious

  9. The situation is an outrageous disgrace. And why is there no effective algorithm at insurance companies to catch this sort of thing?

    Such as on-the-spot drug testing, bearing in mind how long a client has been at a treatment center versus how many days after use a drug can be detected. After all, if the insurance company is paying hundreds of dollars a day, it has some skin in the game.

    For that matter, simply having an insurance company rep show up at the place to do a quick look-see. If the place looks like a crash pad/flophouse, it goes off the insurance company’s approved list.

  10. The situation is an outrageous disgrace. And why is there no effective algorithm at insurance companies to catch this sort of thing?

    Consider the following statement from the link:

    Many of the statements were for expensive drug tests at sophisticated laboratories. Random spot tests cost $5 to $10 each and can be performed once a week or less.

    In contrast, under the fraudulent business model that has taken root in South Florida and elsewhere, certain treatment programs are collecting their patient’s urine three times a week and sending it to a lab for highly sophisticated testing. Instead of $5 to $10, these tests cost anywhere from $1,000 to $4,000, or more.

    That should be EASY for insurance companies to catch. EASY. I wonder if the insurance companies aren’t catching this because they figure the government will reimburse whatever they pay for.

  11. Gringo:

    That’s exactly why I asked the question. It would seem very easy to flag that as unusual, and to investigate.

  12. Humans fall for the con again, as usual and as expected. The sheep think to rule themselves… pretty ridiculous.

  13. I wonder if the insurance companies aren’t catching this because they figure the government will reimburse whatever they pay for.

    It is more likely the nurses union and the doctor associations are getting kickbacks. It’s corrupt to the turtles and beyond.

  14. Not just Florida. From Instapundit: GOLDEN STATE BLUES: How some Southern California drug rehab centers exploit addiction.

    His hair is dirty and matted. His voice is raspy. And on this sunny Tuesday, Solomon is dragging around a bag full of cans and bottles that he hopes to sell to the RePlanet Recycling station behind the Ralph’s in San Clemente.

    He wants to raise $20 so he can get high one last time before he goes into rehab.

    As a kid, Solomon was taught not to steal or use drugs. But today, at 28, he’s grown up to become a shoplifter and a junkie, addicted to heroin and meth and benzodiazepines, one of the hardest drugs to kick.

    Those aren’t the only contradictions in Solomon’s life.

    As broke as he is, Solomon is worth hundreds of thousands of dollars. Chronic drug users like Solomon are commodities, exploited by a growing world of drug and alcohol rehab operators who put profit ahead of patient care. Everything from the opioid epidemic and Obamacare to prison realignment and legal loopholes has created conditions in which unethical operators can flourish, using addicts to bilk insurance companies and the public out of hundreds of millions of dollars.

    Though many legitimate centers remain, critics and long-time insiders say a darker version of the industry is emerging, built around an illicit world of patient recruiters, fraud-driven clinics and drug-testing mills.

    Southern California, where the implementation of Obamacare makes it easy for recent arrivals to sign on for insurance, is on the front line of the conflict.

    More at the link. Unfortunately, government-funded “compassion” often leads to chicanery like this. Not just in sunny Florida and sunny California.

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