“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Ever since President Richard Nixon declared a war on drugs, proponents of this massive federal program have lamented its manifest failure. If only officials would just “crack down” in the war on drugs, drug-war advocates have exclaimed over the years, we could finally win it.
Alas, for more than four decades drug warriors have had to accept reality: their massive federal program has failed. It’s turned out to be a big loser. No one, not even the most ardent drug warrior in the country, has ever been ready to declare victory in the war on drugs.
Moreover, it’s not as if the drug warriors haven’t periodically initiated massive crackdowns in their drug war:
Mandatory minimum sentences that have locked drug-war defendants away for big parts of their lives.
Asset-forfeiture laws that have enabled law-enforcement officials to seize homes, businesses, cars, boats, motels, and other property without filing suit and securing a judgment against the victims.
Surprise violent drug-war raids on people’s homes, including in the middle of the night.
Warrantless searches of people walking down the street.
Warrantless searches of cars traveling on streets and highways.
Fixed highway checkpoints in which cars and occupants are searched, including through the use of drug-war dogs.
All for naught. Despite the crackdowns, the war on drugs has still not been won.
Last year, a 71-year-old Filipino politician named Rodrigo Duterte became president of the Philippines. Immediately, he became a darling of many American proponents of the war on drugs, including even Republican President Donald Trump.
The reason for admiring Duterte?
Duterte promised what American drug warriors have always wanted: a real crackdown in the war on drugs, one that would finally bring victory in this decades-long government program.
Why do I emphasize the word “real”? Because in Duterte’s mind — and in the minds of many American drug warriors — all those steps taken by U.S. officials listed above did not constitute a real crackdown in the war on drugs. A real crackdown would entail simply killing every single person suspected of violating drug laws, including both consumers and sellers of illicit drugs. As Duterte told a crowd on the eve of his 2016 election, “If I make it to the presidential palace I will do just what I did as mayor. You drug pushers, holdup men, and do-nothings, you better get out because I’ll kill you.”
Duterte’s supporters loved it. After all, why bother with arrests, prosecutions, convictions, mandatory-minimum sentences, asset forfeiture, and overcrowded prisons when you can simply kill drug-war violators? What better way to win the war on drugs than that?
According to Human Rights Watch, Duterte’s drug war “has led to the deaths of over 12,000 Filipinos to date, mostly urban poor.”
Despite all extra-judicial killings, however, the war on drugs in the Philippines still hasn’t been won. In fact, every indication is that the war on drugs will continue through the end of Duterte’s term in office and beyond.
Two questions naturally arise:
1. Should U.S. officials employ a real drug-war crackdown here in the United States by implementing extra-judicial killings of drug-war violators, as Duterte has done?
2. What good would it do, given that not even that level of crackdown has brought drug-war victory in the Philippines? Indeed, extra-judicial killings haven’t even brought victory to U.S. officials in their never-ending “war on terrorism.”
While many experts believe involuntary treatment can be effective in dealing with the heroin and opioid crisis in Delaware, there are no surefire answers on how to execute a plan.
“We need every tool in our toolbox to address this epidemic and prevent overdose deaths,” said Dr. Kara Odom Walker, Secretary of the State Department of Health and Social Services.
Odom Walker supports involuntary treatment, but she said the state can’t just deploy the strategy without having regulations, a certification process, observation of how the treatment system would respond.
Attorney General Matt Denn identified other issues.
“The big challenge that other states have faced and not really overcome yet– and that we really have to deal with–is coming up with a facility where you’re actually going to have good outcomes if people were committed there involuntarily,” said Denn. “But I think it is something we should be working towards.”
Kim Jones, is a counselor at Gaudenzia in recovery from heroin and drug addiction, and she said her recovery was born out of involuntary treatment.
“I think in my case, in a way, I actually did go through involuntary treatment, because my treatment was in the federal prison system, so it was certainly effective for me.”
Jones believes involuntary treatment can work and so does Denn, but he said sending innocent people to prison isn’t the answer.
“I think generally speaking prisons aren’t an ideal location for involuntary treatment for somebody who hasn’t committed a crime,” said Denn. “The other types of secure facilities the state currently has aren’t really amendable to it either.”
Dr. Andrew Kolodny, Physicians for Responsible Opioid Prescribing and Heller School for Social Policy and Management at Brandeis University, said more beds aren’t necessarily needed throughout the country to treat the issue.
He stressed that it’s better that someone recovering from a medical problem get better without medication so they don’t get “stuck” on a drug.
Odom Walker said more access to outpatient therapy is needed in Delaware.
Other speakers at Monday night’s forum at John Dickinson High School included Dr. Sandra Gibney, emergency room doctor and associate chairman of Emergency Services at Saint Francis Healthcare, Dr. Terry Horton, chief of addiction medicine at Christiana Care Health System.
Xarelto Bleeding Injury Lawsuit $27M Verdict. According to Bloomberg news report, Johnson & Johnson and its partner Bayer AG were found liable for a woman’s Xarelto bleeding injury.
Xarelto Bleeding Injury Lawsuit $27M Verdict. According to Bloomberg news report, Johnson & Johnson and its partner Bayer AG were found liable for a woman’s Xarelto bleeding injury.
The Pennsylvania jury slapped the pharmaceutical giant companies and ordered them to pay almost $28 million in damages. To fight the best for your cases, it is advisable to hire the attorneys who help in car accident injury claims in Tampa as they are the toughest and best in their field who assure the client to deliver the correct judgment for their cases.
Plaintiff nearly bled to death
According to Lynn Hartman, she took Xarelto, sold by J&J’s Janssen Pharmaceuticals unit, for more than a year before being hospitalized in 2014 with severe gastrointestinal bleeding.
The jury noted $1.8 million in actual damages and $26 million in punitive damages, to punish the companies for their wrongful acts.
What is Xarelto?
Xarelto belongs to a new class of oral anticoagulants drugs replacing Coumadin, which has been the go-to anticoagulant since the 1960s.
Critics of Xarelto stress that the drug has no antidote, so it puts some users at high risk for bleeding out if they suffer an injury. Coumadin’s blood-thinning effects can be reversed.
While Xarelto is the market leader for new generation anticoagulants, Boehringer’s Pradaxa anticoagulant has one major advantage over the others: A reversal agent was approved for it in a case of uncontrolled bleeding.
Xarelto Bleeding Injury Lawsuits
Johnson & Johnson and Bayer won the first three cases to come to trial in federal court after juries found the drug was safe and the companies properly warned about Xarelto’s bleeding risks.
The drug companies are exposed to more than 20,000 Xarelto suit injury claims.
Xarelto linked to patient deaths
Xarelto has been linked to at least 370 deaths, according to U.S. Food and Drug Administration reports.
Xarelto is a Blockbuster drug
Xarelto is Bayer’s top-selling product, raked in $3.2 billion in sales last year. Bayer is headquartered in Germany. Xarelto is J&J’s third-largest seller, grabbing $2.3 billion in sales in 2016.
During the trial, ex-FDA Chief David Kessler told the Philadelphia Common Pleas Court that the companies’ Xarelto warning labels minimized the drug’s bleeding risks and didn’t warn doctors that some patients would be at higher risks for bleed outs.
The case is Lynn Hartman v. Janssen Pharmaceuticals Inc., Case No. 160503416, Court of Common Pleas of Philadelphia County, Pennsylvania.
If you or a loved one used Xarelto and have suffered injuries or wrongful death with the medication, contact the Dr. Shezad Malik Law Firm to learn more about your legal rights. You can speak with one of our team by calling toll-free at 888-210-9693, 214-390-3189 or by filling out the case evaluation form on this page.
ALEXANDRIA, Va. (Dec. 4, 2017) — In a statement, National Community Pharmacists Association CEO B. Douglas Hoey, Pharmacist, MBA, says the announced merger of CVS Health and Aetna may not create its purported cost savings, and that there may be detrimental effects on consumers and community pharmacy providers:
“For all of the talk about cost savings, prescription drug costs have clearly continued to rise despite previous vertical mergers like UnitedHealth’s 2015 acquisition of Catamaran. Moreover, the anticipated efficiencies CVS and Aetna tout may benefit the merged company more than the consumer, who is likelier to be driven to use health care resources chosen by the health plan rather than those of his or her own choosing.
“As regulators review whether or not to approve this acquisition and evaluate the potential impact on consumers, previous and current behavior should be a point of reference. Cases in point:
CVS/Caremark is already the pharmacy benefits manager for Aetna, and independent pharmacies have been foreclosed from Aetna’s Part D preferred networks for the last two years. Consolidation of the two companies will only strengthen their ability to steer patients to CVS/Aetna-owned retail or mail order pharmacies.
“We believe that one possible driver for this merger is the increased scrutiny on the role pharmacy benefit managers play and the growing evidence that they contribute to the higher costs of prescription drugs. The main source of purported cost savings touted by CVS and Aetna may be in containing the costs PBMs add to prescriptions.
“Control and manipulation of patient data is also a concern. Consumers should have the freedom to choose the providers that produce the highest quality health outcomes and cost-effectiveness, rather than being coerced into using certain physicians or pharmacies.
“In short, bigger is not always better. A close examination of whether this acquisition will lead to higher drug prices and fewer quality and convenience options for consumers is warranted.”
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The National Community Pharmacists Association (NCPA®) represents the interests of America’s community pharmacists, including the owners of more than 22,000 independent community pharmacies. Together they represent an $80 billion health care marketplace and employ more than 250,000 individuals on a full- or part-time basis. To learn more, go to www.ncpanet.org, visit facebook.com/commpharmacy, or follow NCPA on Twitter @Commpharmacy.
Medical-marijuana businesses will not have a home in New Albany as long as cannabis is illegal under federal law, according to city leaders.
New Albany City Council on Nov. 28 voted 6-0 to become the latest central Ohio city to ban medical-marijuana businesses.
Mayor Sloan Spalding, President Pro Tempore Colleen Briscoe and Marlene Brisk, Mike Durik, Chip Fellows and Matt Shull voted in favor of the ordinance. Glyde Marsh was absent.
As a result of the ordinance, marijuana cultivation, processing and retail dispensing are prohibited in New Albany.
City attorney Mitch Banchefsky cited medical marijuana’s illegal standing under federal law as the reason New Albany moved forward with the ban.
Although medical marijuana now is legal in Ohio
and the federal government isn’t enforcing laws banning it, nothing would prevent the federal government from doing so in the future, he said.
“It all comes back to the federal issue again,” he said.
Should the federal government change its laws regarding medical marijuana, New Albany would revisit its ban, Banchefsky said.
RIVERSIDE, Calif. (AP) — A former California state lawmaker was charged with providing a gun to his wife so she could kill herself last year.
Former Assemblyman Steve Clute was charged Thursday in Riverside County Superior Court with a felony count of aiding the suicide of his wife of about 40 years.
Pamela Clute, 66, a well-liked math professor and administrator at the University of California, Riverside, was found dead in the couple’s Palm Desert home in August 2016. About 500 people attended a campus memorial service for her.
Steve Clute, 69, a former Navy pilot who served as a Democrat in the state Assembly from 1982 to 1992, allegedly gave her the handgun she used to take her life, John Hall, spokesman for the Riverside district attorney, said Monday.
Defense lawyer Virginia Blumenthal said Clute would plead not guilty at his arraignment Wednesday. She said it was premature to discuss his defense, but noted he was not present “at the time gun went off.”
Clute is devastated by the criminal charge that comes after more than a year of grieving.
“You have to understand that everyone around here knows how much in love he was with her,” said Blumenthal, who was friends with the couple for four decades. “They were always together. They were very much in love with each other.”
Pamela Clute had been suffering from agonizing back problems and medical treatment had failed to relieve pain that shot down her legs, Blumenthal said.
While California’s assisted suicide law went into effect a couple months before Clute’s death, the law only applies to terminally ill patients who are prescribed life-ending drugs by a physician. Clute wasn’t terminally ill.
Blumenthal, who has practiced law for more than 40 years, said it was the first case of its kind she was aware of in Riverside County.
Hall said he wasn’t immediately aware of whether the charge was unusual.
On Sunday, CVS and Aetna announced what would be one of the largest health care deals of all time. The retail pharmacy giant agreed to buy the health insurer—one of the biggest in America with more than $63 billion in 2016 revenues—in a deal valued at $69 billion. And, if approved by the companies’ boards and federal regulators, the corporate marriage has the potential transform the way the health industry does business and how millions of Americans receive their medical care.
Consolidation is certainly nothing new in the U.S. health care sector. Traditional pharmaceutical giants regularly scoop up leaner, meaner biotechs to insource drug innovation; hospital chains join forces to grapple with shifting reimbursement models. But, within the insurance industry, recent attempts to integrate horizontally—such as Anthem’s bid for fellow insurer Cigna and Aetna’s proposed deal for rival Humana—have faced roadblocks over antitrust concerns. Both those proposed M&As died following regulatory pushback.
Those failures may be, in part, what helped prompt a different kind of consolidation strategy for CVS and Aetna. Unlike going horizontal within their own industries, a deal with each other would present a more diversified consolidated company that moves vertically through the health care supply chain and could provide consumers with a new kind of health care experience, the firm’s top executives argue. CVS’ pharmacies and in-store MinuteClinics would gain access to Aetna’s millions of plan holders, including its giant footprint in the employer health coverage market; Aetna customers would be able to walk into a local CVS pharmacy to discuss primary care treatment options and get their prescription drugs without having to trudge through the various middlemen that pepper America’s fragmented medical system. Consider: CVS is also one of the largest pharmacy benefit managers in the country through its Caremark arm, so insurance coverage, filling prescriptions, and treating chronic health conditions like diabetes could all be housed under one company.
“[I]t’s really the perfect time to bring these two companies together, to create a new health care platform that can be easier to use and less expensive for consumers, and really create a new front door to health care in our country,” CVS Health CEO Larry Merlo told CNBC on Monday. Aetna chief Mark Bertolini added that there would be about 10,000 of these new “front doors” created by the merger thanks to CVS’ ubiquitous pharmacies and clinics. (My Fortune colleague Phil Wahba has a great piece on what CVS stores could look like if the Aetna deal goes through.)
One broader result of the deal may be an even larger push for cross-sector mergers—especially with the specter of Amazon reportedly vying for a foothold in the pharmacy business. Leerink Partners analyst Dr. Ana Gupte has argued that a successful CVS-Aetna M&A could spur Wal-Mart to pursue a deal with insurer Humana, with which the retail titan has a long-standing relationship.
But the critical question will be whether such deals will ultimately prove fruitful for patients. Merlo and Bertolini say the cost-savings and efficiencies will clearly cut costs for consumers. Critics, though, point out that driving customers to fewer and fewer options across the gamut of health services could prove risky for them in the long run.
Just think about it… once a pt gets “entangled” in CVS being in charge of your healthcare. You will be dealing with one huge FOR-PROFIT A COMPANY…
The insurance arm of the new company could “cut a deal” with various hospitals, labs and other services and put in place financial incentives or disincentives for those covered by their insurance program.
Between their insurance arm and their PBM arm ( Caremark) they could “cut deals” with pharmas where they are putting financial incentives or disincentives where “therapeutic substitution” is their SOP… we are not taking generics being substituted for a brand name.. but.. they will only pay for a particular medication is a specific therapeutic category.. that they have deemed to be what is “best” for all of their beneficiaries… think what can be purchased for the least cost/day for therapy.
Aetna currently offers Medicare Advantage programs and of course, now you will be enrolled in Silver Scripts that is CVS’ Medicare Part D prgm and is managed by their PBM Caremark.
Then they now own Omnicare.. the largest nursing home pharmacy provider in the country… which the vast majority of nursing home residents are on Medicare and use a Part D provider… how much are they going to be able to self-refer those pts to the Aetna Advantage prgm and/or Silver Scripts Part D prgms ?
Often in nursing home.. especially those classified as SNF (Skilled Nursing Facility) where they take care of sickest of those staying in a nursing home and being transferred out to hospitals is pretty normal.. will these pts now mostly/exclusively be ambulance transported to “CVS partner hospitals ” ?
I am sure that the “number crunchers” at CVS will find other venues in which to move money from the pt’s pocket to their bottom line.. while making the pt believe that they are getting the best care available.
After all, the primary focus of a publicly held for profit company is to increase their stock price and bottom line profits ..
The only “Obamacare” health insurer in metro Phoenix and Pima County is ensnared in a legal dispute with several addiction treatment centers over the cost of care amid an Arizona opioid epidemic that is taking an average of two lives each day.
Nine alcohol and drug rehabilitation centers claim in a Maricopa County Superior Court lawsuit that the health insurance company Health Net of Arizona improperly withheld or delayed lucrative payments for treatment of people struggling with addiction.
But Health Net says in a counterclaim that there was widespread fraud among Arizona and California drug rehab centers in 2015 and 2016, when it alleges”teams of brokers” recruited out-of-state clients to fraudulently obtain insurance policies and to seek treatment in Arizona.
Those actions have cost the insurance company — and Arizona consumers through higher monthly premiums — tens of millions of dollars, the Health Net counterclaim says.
The lawsuit reveals the financial engine of a booming rehab industry that has fed the growth of facilities aiming to get and keep people off alcohol and drugs such as opioids and heroin.
The growth of rehab centers corresponds with the rise of residential “sober homes” that have sprouted in upscale neighborhoods of Phoenix, Paradise Valley, Scottsdale and other communities in metro Phoenix.
The proliferation of these homes pits residential neighbors against rehab entrepreneurs in standoffs that have created headaches for local government officials as they try to determine how to manage the unregulated industry.
Prescott, which once claimed more than 100 sober homes, has adopted regulations to provide more oversight of them.
The sober homes provide a safe haven for people trying to overcome drug or alcohol addictions. These homes generally do not provide treatment, but people living in them often seek outpatient treatment from affiliated rehabilitation clinics.
Arizona’s rehabilitation industry has caught the attention of regulators in other states.
The Massachusetts attorney general this year warned consumers to be wary of solicitations to enter rehab in Arizona, Florida and California. Federal and state prosecutors have aggressively pursued cases in Florida and California in connection with fraudulent activities such as patient brokering.
There have been no criminal cases filed in Arizona, however.
Six of the rehab facilities that accuse Health Net of improperly withholding payments are in Prescott: Chapter 5 Counseling, Prescott House, Compass Recovery Center, Clean Adventures of Sober Living, Decision Point Center and Carleton Recovery Centers.
Three others, T R U Recovery Solutions, North Ridge Counseling and Desert Cove Recovery, list Scottsdale addresses.
The rehab facilities allege that Health Net improperly withheld payments to virtually every rehab center in Arizona and southern California beginning in January 2016. Health Net halted the payments as part of an investigative audit that demanded each center provide detailed records such as proof of patients’ residency and assurances that patients did not receive incentives to sign up for rehab.
Health Net did not resume making payments until May 2016, the lawsuit states. By then, the rehab centers were financially squeezed and even had to turn away Health Net-insured clients.
“We’ve had treatment centers that have had to close their doors due the lack of payments,” said John Flynn, a Phoenix attorney who represents Arizona and California rehab facilities in separate lawsuits filed in each state. “Patients were sent away because they could not (afford to) address their needs.”
The Arizona lawsuit also claims that Health Net issued inaccurate financial statements in late 2015 and early 2016 because it did not report an estimated $150 million in claim payments owed to the rehab centers. Health Net was acquired by St. Louis-based Centene Corp., which later restated the financial statements to reflect the claim payments, the lawsuit stated.
A California lawsuit filed by multiple rehab businesses, including Shreya Health of Arizona and Sovereign Health of Arizona, claims Health Net refused to pay $55 million in medically necessary services. Shreya Health and Sovereign Health both have facilities in Chandler.
According to a new government study, rising death rates from opioid abuse are lowering Americans’ life spans. NorthJersey.com
Soaring claims
Health Net said in court documents that claims filed by rehab centers in Arizona soared because of widespread fraud. Health Net representatives, citing ongoing litigation, would not discuss the case with The Arizona Republic.
However, Health Net said in a counterclaim that the fraud involved Health Net’s “preferred provider,” or PPO, plans that paid benefits to rehab centers that were not part of the insurer’s network.
In-network providers typically agree to offer services at negotiated discounted rates, and consumers typically pay less out of pocket for in-network claims. But consumers typically have to pay a larger share of the bill from out-of-network providers, which are not obligated to charge negotiated, discounted rates.
Health Net’s PPO plans paid $2.4 million to all Arizona rehab centers in 2014. Those payments soared to $47.4 million in 2015. Those plans paid more for rehab care that year than all other types of care in Arizona, including typically expensive medical care such as cancer, heart disease and child births, according to the insurer’s counterclaim.
Those higher insurance costs, which Health Net alleges resulted from fraud, are collectively paid by all customers in the form of higher premiums, the insurer said in court filings.
The nine centers that Health Net sued in its counterclaim had collectively billed the insurer $28 million from January 2015 through September 2016, the lawsuit stated.
Here’s how the fraud worked, the insurer said in its counterclaim:
Brokers would scout out people in 12-step programs, Alcoholics Anonymous meetings, homeless shelters and jails, then refer these clients to the “highest-bidding clinic.”
Clinics that were not part of the insurer’s network paid clients’ insurance premiums and out-of-pocket costs such as deductibles and co-payments.
The result was that people secured Health Net coverage “arranged and bought for them by financially-interested providers for one purpose only: to obtain coverage for the limited time needed to rack up millions of dollars in substance abuse treatment.”
Some clinics misrepresented the home addresses of patients, many of whom lived out of state.
Health Net said that the Arizona centers, and others, engaged in “a sophisticated fraud involving the fraudulent enrollment of non-Arizona residents,” who signed up for Arizona insurance policies.
Even though “many, if not most” prospective clients lived out of state, they were signed up for Health Net PPO plans for Arizona residents, often misrepresenting their home address on applications, according to the counterclaim.
The insurer described examples of two New York residents enrolled in a Health Net plan and encouraged to get treatment at Clean Adventures of Sober Living in Prescott.
Here are some facts about heroin and other opioids. Video by Jordan Fenster/lohud Wochit
One New York patient, identified as M.B., reportedly told a Health Net investigator that a Clean Adventures staff member told him to list the rehab facility’s address on his insurance application.
A second New York patient, identified as J.S., told an investigator a Clean Adventures staffer put him in contact with an insurance agent who suggested using Clean Adventures’ address on his insurance application, the counterclaim stated.
The insurer named 10 other examples of people who lived in California, Indiana, New Jersey, New York, Tennessee and Wisconsin but represented that they lived in Prescott or Scottsdale. The insurer did not identify which rehab centers those individuals used, but said they were among the nine rehab centers in the counterclaim.
Health Net said that the treatment centers often purchased and paid for the insurance policies but did not disclose this to patients, who were often told they were eligible for a “scholarship program” that covered rehab costs.
The insurer also said the rehab centers engaged in fraudulent billing, charging for services that were not medically necessary or in amounts that exceeded what the plan allowed.
Health Net said the centers inflated the bills so they could collect from the insurer costs that should have been paid by consumers, such as co-payments and coinsurance.
The counterclaim also says the nine Arizona centers billed Health Net less than $56,000 in January 2015. However, during a one-year period through July 2016, those substance-abuse facilities billed Health Net more than $12.5 million.
The counterclaim asks the court to award damages in an amount to be proven at trial and to order the centers to cease engaging in those business practices.
The rehab centers deny any wrongdoing in an answer to the counterclaim.
Flynn noted that the case is in discovery. He said his team has yet to receive all documentation requested from Health Net, including documents supporting allegations listed in the counterclaim.
Doctors are cutting back on opioid prescriptions but not by nearly enough, federal health officials say. Wochit
Confluence of laws
Arizona rehab industry officials said it appears a small number of rehab centers took financial advantage of a confluence of federal laws.
A 2008 law called the Mental Health Parity and Addiction Act requires insurance plans to provide equitable coverage for substance abuse and addiction treatment. The Affordable Care Act also requires health insurance plans cover essential health benefits, including behavioral health services, and it forbids insurers from denying coverage to individuals based on existing medical conditions.
“The unintended consequence was (some) addiction treatments centers began taking advantage of that and over-billing,” said Angie Geren, executive director of Addiction Haven, a grassroots and advocacy organization focusing on addiction issues.
Geren said that while the vast majority of Arizona centers have not engaged in such activity, the state’s reputation has been harmed by the actions of those that did.
Massachusetts Attorney General Maura Healy earlier this year warned that her office received reports of individuals trying to recruit people to “so-called treatment centers in Arizona, California or Florida.”
Healy warned residents to be wary of addiction-treatment centers that arrange out-of-state travel or offer to cover insurance payments. Individuals who arrange for addiction treatment may be getting payments from the rehab centers they are recruiting for.
Massachusetts has a law that prohibits the receipt of payments or kickbacks for referring a patient to treatment.
Arizona Rep. Noel Campbell, R-Prescott, earlier this year introduced House Bill 2333 that sought to curb the practice of paying referral fees to brokers who steer patients to rehab centers.
Under Campbell’s bill, referrals of more than $1,000 would have triggered a Class 3 felony charge with a possible penalty of 3.5 years in prison. However, the bill never made it out of committee.
Florida has enacted “patient-brokering” laws aimed at eliminating such activity at rehab homes there. Prosecutors also have aggressively pursued criminal charges.
Dave Aronberg, the state attorney for Palm Beach County, Fla., said law enforcement there has arrested 41 individuals. The most common charge involved violation of the state’s patient-brokering law, he said
“The scam starts with deceptive advertising at the beginning,” Aronberg said. “You are lured down to sunny Florida with a free plane ticket, which is illegal. You are given illegal benefits to keep you there.”
But Aronberg said patients often find themselves booted from treatment when their insurance benefits run out. That creates an incentive for people to relapse so they can obtain another round of coverage.
Aronberg’s office has started a Sober Home Task Force targeting the practice of buying and selling patients battling addiction. His office also has received leads and information about similar activity in other states, including Arizona and California, particularly Orange County.
Alan Johnson, a Palm Beach County chief assistant state attorney who oversees the county’s sober-home task force, said sober homes have sprouted in communities there. These homes provide out-of-state patients a place to live while they undergo drug treatment.
A key funding source for the rehab centers, which often work in tandem with sober homes, has been urinalysis testing. These tests, for which the centers charged large and repetitive fees, proved lucrative from 2014 through 2016. However, insurers are beginning to scrutinize payments for such tests more closely.
Johnson said rehab centers that provide legitimate services are being harmed as insurance companies scrutinize payments and bad actors poach patients away.
“There’s less gravy in the gravy train,” Johnson said.
Reach the reporter at ken.alltucker@arizonarepublic.com or 602-444-8285.
