USA TODAY International Edition
Our view: ‘Patient brokers' getting treatment they deserve
As if people addicted to opioids don't have enough trouble, shady operators have found a way to exploit them. Across the county, these “patient brokers” troll streets, drug courts and anywhere they might find people with addiction problems to lure them to treatment centers and “sober living homes” in exchange for kickbacks. Internet and TV ads often promote the illegitimate facilities. And some phone hotlines, while offering to connect callers to legitimate treatment, instead sell referrals to the highest bidder. The scam is known as patient bro- kering, with brokers focused on profits instead of matching sick people with appropriate treatment. In a country with 2.1 million people suffering from opioid addiction, business is booming. While kickbacks involving facilities that take Medicaid or Medicare have been illegal since 1972, this shady business has been legal when it involves private insurance, including policies sold under the Affordable Care Act. That's about to end. A bipartisan measure, pressed by Sens. Marco Rubio, R-Fla., and Amy Klobuchar, D-Minn., and passed by Congress as part of a package designed to battle the opioid epidemic, would prohibit such kickbacks. Once the law is signed by the president, at a ceremony scheduled for today, federal prosecutors will finally be able to go after patient brokers and the providers who pay them. Conviction for taking or providing kickbacks will carry criminal penalties of up to 10 years in prison. Victims of this vicious business range from desperate people battling addiction to anyone who buys health coverage. Because many of the illicit centers overcharge insurers for services, insurance rates rise for everyone. Most tragically, it can lead to death. Patients weaned from opioids at disreputable facilities exit with a lower tolerance for such drugs. If they relapse, they can easily overdose on an amount they previously tolerated. That's especially risky today, with the prevalence of opioids and heroin laced with fentanyl, a potent synthetic opioid. Many of the illicit rehabs and homes are in Florida and California, where warm weather helps entice treatment seekers from the Midwest and the Northeast. Malibu, for example, has 47 rehab centers, the highest per capita concentration in California. Palm Beach County has become a haven for “unscrupulous individuals” preying on addicted patients by offering inducements — such as free, one-way plane tickets, free rent and even drugs — to come to facilities, the county's prosecutor Dave Aronberg told a congressional panel. Too many, he said, “leave our community only in ambulances or body bags.” Addicted individuals and their worried loved ones are easy prey because finding effective, professional treatment is so difficult and confusing. Consulting with a family doctor or with guides put out by trustworthy sources, such as the National Institute on Drug Abuse or the federal Substance Abuse and Mental Health Services Administration, can help. Most important is avoiding centers that advertise implausible claims of success, internet hotlines and anyone offering inducements, such as free plane tickets or rent. Treatment center regulation is a patchwork of state laws, and clearly more stringent licensing and oversight of centers and sober living homes are needed so people will not have to wade through a thicket of questionable choices. But the first step is cracking down on shady patient brokers and providers. Once the law is signed, they will be marked as what they really are — criminals preying on society's most vulnerable.