Breaking News
August 21, 2018 - Clinical Trials Balance Out Urban, Rural Cancer Survival Rates
August 21, 2018 - New target found for treating thoracic aortic aneurysm
August 21, 2018 - Tumor cells’ ‘tells’ may allow some cancer patients to dodge unnecessary chemotherapy
August 21, 2018 - Dehydration changes shape and activity of the brain, reduces task performance
August 21, 2018 - Scientists discover peptides that can be used as new antibiotic candidates
August 21, 2018 - ‘Compulsivity circuit’ may drive alcohol-seeking behavior in heavy drinkers
August 21, 2018 - Type 2 diabetes on the rise among youngsters
August 21, 2018 - Genital warts may promote HIV sexual transmission
August 21, 2018 - Drop the C-word to reduce anxiety and overtreatment, say experts
August 21, 2018 - Kid-friendly MRI equipment has advantages for grown-ups, too
August 21, 2018 - Scleroderma Foundation names Tulane professor as ‘Doctor of the Year’
August 21, 2018 - Chagas disease causes chronic heart disease and has spread outside of Latin America
August 21, 2018 - FDA stirs debate by approving ‘natural’ app
August 21, 2018 - Clay may help fight disease-causing bacteria in wounds
August 21, 2018 - Emerging field of diabetology could address growing crisis in health care
August 21, 2018 - Experts examine stool protein biomarkers that indicate inflammatory bowel disease
August 21, 2018 - Orphazyme Announces Enrollment of First Patient in Phase III Clinical Trial of Arimoclomol for ALS
August 21, 2018 - Ovarian cancer cells hoard iron to fuel growth
August 21, 2018 - New Biodesign fellows will focus on vision care
August 21, 2018 - Prenatal DDT Exposure Associated with Greater Risk of Autism
August 21, 2018 - Cruciferous vegetables found to protect against colon cancer in mice
August 21, 2018 - New studies point to a promising future for bioengineered teeth
August 21, 2018 - ACR expresses concerns on step therapy in a recent meeting with HSS Secretary
August 21, 2018 - Gene therapy with telomerase does not increase cancer risk, study shows
August 21, 2018 - Ovarian cancer screening influenced by unconscious bias, study shows
August 21, 2018 - Scientists report novel gene therapy that halts vision loss in canine model of blinding disease
August 21, 2018 - RxBenefits introduces new tailored and flexible approach to managing hospital pharmacy benefits
August 21, 2018 - Motif Bio Announces FDA Acceptance of New Drug Application With Priority Review for Iclaprim for Treatment of Acute Bacterial Skin and Skin Structure Infections
August 21, 2018 - Google Glass helps kids with autism read facial expressions, study finds
August 21, 2018 - Thrombospondin-1 contributes to development of aortic aneurysm in mice and humans, study finds
August 21, 2018 - National Foundation for Cancer Research receives Safeway Foundation grant
August 21, 2018 - Protein aggregation in neurons linked to gene regulation in Huntington’s disease
August 21, 2018 - Aravive Biologics gains Fast Track Designation for AVB-S6-500 from U.S. FDA
August 21, 2018 - FDA Approves Opdivo (nivolumab) for Certain Patients with Previously Treated Small Cell Lung Cancer
August 21, 2018 - Success of blood test for autism affirmed
August 21, 2018 - Diabetic patients with disrupted sleep may need more time to heal their wounds
August 21, 2018 - AADE honors six educators for achievements in diabetes education
August 21, 2018 - Scientists find two molecules that may combat cancer and chronic infections
August 21, 2018 - Two Strategies for Preventing Diabetes in Minority Patients
August 21, 2018 - Living as a Gallbladder Cancer Survivor
August 21, 2018 - Can we predict the long-term outcome of boys with ADHD?
August 21, 2018 - GBCA creates model for developing scientist-advocate collaborations in cancer research
August 21, 2018 - Healthy diet could help promote healthy cellular aging in women
August 21, 2018 - Researchers develop gene expression predictor for immunotherapy response in melanoma
August 21, 2018 - Genome sequences of ape parasites provide insights on origin and early evolution of malaria
August 21, 2018 - MDI Biological Laboratory introduces Morris Scientific Discovery Fund for eligible research programs
August 21, 2018 - Pediatric brain tumor patients who undergo radiation less likely to recall recently experienced events
August 21, 2018 - Micro-flow model reveals complex interactions between the brain’s blood vessels and nerve cells
August 21, 2018 - Study investigates impact of osteoporosis on risk of developing dementia
August 21, 2018 - Federal method fails to detect most stores that sell cigarettes to minors
August 21, 2018 - Workers in open office seating have less stress than those in private offices and cubicles
August 21, 2018 - 1 in 4 in U.S. Has a Disability, CDC Reports
August 21, 2018 - Studies provide new insights into the role of sleep in chronic pain
August 21, 2018 - Study shows that rogue proteins may underlie some ALS and frontotemporal dementia cases
August 21, 2018 - Elevated LDL cholesterol levels linked to higher risk of CVD death in young, healthy people
August 21, 2018 - Measles cases on the rise in Europe
August 21, 2018 - CURE Media Group welcomes CancerCare to Strategic Alliance Partnership Program
August 21, 2018 - Blood management program associated with fewer transfusions in orthopedic patients
August 21, 2018 - Researchers create the world’s first artificial retina
August 21, 2018 - Yale researchers identify racial disparities in prescribing opioids for chronic pain
August 21, 2018 - BOOST-3 clinical trial aims to improve outcomes for severe TBI patients
August 21, 2018 - New study highlights Alzheimer’s herpes link, experts say
August 21, 2018 - Airline crew don’t have significantly elevated risk of thyroid cancer, new study finds
August 21, 2018 - States leverage federal funds to help insurers lower premiums
August 21, 2018 - New badge course explores research around skeletal muscle as an endocrine organ
August 21, 2018 - TG Therapeutics Announces Completion of Target Enrollment in the ULTIMATE Phase 3 Trials in Multiple Sclerosis
August 21, 2018 - Increased levels of human herpesvirus ID’d in Alzheimer’s
August 21, 2018 - To help patients quash pain, researcher develops practical guide for health care providers
August 20, 2018 - Medicine on the front line to be presented at Medical Innovation 2018
August 20, 2018 - Harbour Biomed and Kelun-Biotech collaborate to develop, commercialize anti-PD-L1 antibody
August 20, 2018 - The man who sold America on vitamin D — and profited in the process
August 20, 2018 - Finding the light in antimicrobials
August 20, 2018 - Unique pain program helps surgical patients wean off opioids safely and effectively
August 20, 2018 - Strawberries could mitigate colonic inflammation
August 20, 2018 - FDA Accepts New Drug Application (NDA) to Review Midazolam Nasal Spray, an Investigational Product for the Acute Treatment of Seizure Clusters
August 20, 2018 - Using Facebook to help young adults quit smoking
August 20, 2018 - ‘Liquid biopsy’ predicts lymphoma therapy success within days | News Center
August 20, 2018 - 5 Questions with Jordan Orange, Chair of Pediatrics
August 20, 2018 - New assay may help improve both sarcoma diagnosis and treatment
August 20, 2018 - New information on the brain regions related to metacognition, tactile sense
Help States Deter ‘Patient Brokering’, Lawmakers Told

Help States Deter ‘Patient Brokering’, Lawmakers Told

image_pdfDownload PDFimage_print

WASHINGTON — “Brokering” of addiction treatment patients is becoming a nationwide problem, but there are actions the federal government could take to help states and localities crack down on this activity, experts told lawmakers.

“In July 2016, our office formed a task force to crack down on this,” Dave Aronberg, the state’s attorney for Palm Beach County, Florida, said at Tuesday’s House Oversight and Investigations Subcommittee hearing. He noted that the task force has arrested 41 people and scored 10 convictions so far. “But we can’t fix this problem alone.”

Because treating addiction can be a lucrative business, some companies that operate in Florida and purport to treat substance abuse patients will hire people as marketers or call center operators; their job is to encourage patients to come in from out of state to receive treatment at an addiction center, or to stay at a “sober house” to integrate back into society once they have finished treatment, Aronberg explained.

Often, these facilities provide little or no addiction treatment, and the sober houses are more like flophouses and don’t provide the help they advertise, but the marketers get paid commissions or kickbacks for each person they sign up. They lure patients with offers of free travel, free rent, and other benefits.

“Together, the ACA [Affordable Care Act] and the [mental health] parity act cover rehabilitation on a traditional fee-for-service basis with no yearly or lifetime limits,” he said. “In recent years, there is a surge of people who have enriched themselves by using these laws to prey on addicts, who are often willing to participate in patient brokering, illegal kickbacks, and insurance fraud in exchange for illicit benefits such as cash, free rent, transportation and [even] drugs. This is the ‘Florida Shuffle.'”

And, because relapses are also covered, companies have an incentive for people not to get well — and will even go so far as to offer sober house residents drugs in order to make them relapse. “We are incentivizing failure,” Aronberg said.

Massachusetts has seen the problem from the other side, with patients leaving the state to get what they think will be effective treatment for their addictions, said Eric Gold, an assistant attorney general for healthcare in the state. “Our office began hearing stories of men and women from Massachusetts lured out of state by recruiters who promised free travel to addiction treatment centers, [but] when they arrived, they found that treatment was low-quality or non-existent, and they were left thousands of miles from home with no treatment, no resources, no insurance, and no way to return home.”

The witnesses had several recommendations for committee members to consider. “Address private insurance abuses by adopting the ACA’s outcome-based reimbursement model — which is used in Medicare — instead of the current fee-for-service model,” said Aronberg. “That will reward the best recovery centers while shuttering rogue operators. It could also improve outcomes as providers are incentivized to offer longer, lower-level care instead of ineffectual short bursts of intensive treatment with no follow-up.”

He also suggested clarifying the Americans with Disabilities Act (ADA) and the Fair Housing Act (FHA) to specifically allow localities to enact regulations for the health and safety of sober home residents. “These agencies [tried to clarify the rules] last year, but they seemed to miss the point … [Their clarification] seemed to ignore the realities on the ground and did not give any good guidance … We want to know, can we require mandatory certification of these facilities? They didn’t answer that.”

The city of Boca Raton tried to zone sober homes into an industrial area a few years ago, but the city got sued and lost, and was forced to pay out $3 million, he added. “The ADA and FHA were designed to protect individuals, but in reality they are used as a shield to protect the people who harm these folks.”

Douglas Tieman, president and CEO of Caron Treatment Centers, an addiction treatment provider, said that lawmakers “must [enforce] the laws currently on the books and must come up with other regulations that address [treatment] website accuracy and transparency … We need to establish standards in the treatment field and work with associations to establish standards for marketing, evidence-based treatment, and ethical billing.”

Currently, the National Association of Addiction Treatment Providers and the American Society of Addiction Medicine are developing standards in these areas, and hope to soon release a list of treatment providers who follow ethics standards, Tieman said.

Subcommittee member Morgan Griffith (R-Va.) said he was concerned because his district is already short on addiction treatment facilities, “and I know at least one in my district that pays either on volume or commission … If we eliminate [payment based on] commissions and volume, I fear we may be limiting access to substance abuse treatment itself.”

But Alan Johnson, the chief assistant state’s attorney in Palm Beach County and a colleague of Aronberg, said he had “not heard a compelling argument for why an employee needs to have commissions or bonuses. When you give someone a commission, you incentivize overutilization.”

Rep. Raul Ruiz (D-Calif.) suggested that the Substance Abuse and Mental Health Services Administration (SAMHSA) could develop best practices for addiction treatment facilities, and allow places that meet those criteria to receive certification for it. “I think SAMHSA could provide something like this, and I know I could get bipartisan support from the committee as well,” he said.

2017-12-13T17:15:00-0500

Tagged with:

About author

Related Articles