It’s not completely understood why there are so many forms of addiction treatment center fraud out there, but one reason could be the long-standing stigma associated with substance use disorder (SUD), a mental health and behavioral disorder. 

Research shows that people who seek help for addiction can experience negative biases and prejudice on the part of healthcare professionals and society in general. This makes scams and fraudulent practices in the recovery space more prevalent, underreported, and dangerous. In fact, this is an issue that patients, families, and legitimate care centers and insurance companies are dealing with consistently. 

At St. Joseph Institute For Addiction in Port Matilda, we’re committed to fighting against addiction treatment center fraud in its many forms because we view it as a crime and a huge obstacle to quality care. We’re also here to provide legitimate health services like our residential treatment program, and therapy programs, and offer recovery education resources. Keep reading to get a better idea of recovery fraud and how to fight against it.

The Most Common Forms of Addiction Treatment Center Fraud in Pennsylvania 

Fraudulent practices in addiction recovery centers prey on people’s vulnerabilities, medical limitations, and financial worries. There are six major forms of recovery center fraud:

• Patient brokering
• Patient bribery
• Hacked business listings
• Service and program misrepresentation
• Violations of patient privacy and information
• Insurance over-billing and insurance fraud

Patient brokering is typically regarded as one of the most prevalent of these common fraudulent practices and is typically driven by two predatory strategies: lead selling and lead buying. 

Patient brokering that involves lead selling will often rely on addiction tourism to fully play out. Addiction tourism is the practice of sending someone out of state for addiction treatment with financially motivated intentions. 

In many legitimate cases, such as leaving your home state to attend treatment in Port Matilda, Pennsylvania, travel is completely warranted—as our facility is certified and adherent to all legal medical and billing procedures. In more suspicious situations, where call centers or insurance agents offer travel vouchers or financial compensation to cover travel to the facility or incentivize enrollment, you should immediately be aware of the potential for lead selling. 

Lead buying, on the other hand, involves bidding patients to the highest-paying treatment centers. Insurance agents will auction off patients with different types of addictions. The patients with the best insurance policies or the highest out-of-pocket costs who prove most lucrative to the addiction center will be accepted for treatment. Other treatment centers can then deny those patients, as they’ve been “sold” to a competitor. If you’re finding that you’re being barred from other treatment centers but accepted by a sole competitor, this could be one reason why. 

Other Common Addiction Treatment Fraud Examples To Be Aware Of

Patient bribery is pretty straightforward. If you’re offered money, travel accommodations, gifts, or other incentives to stay in treatment, prolong care, or attend another treatment facility after completing a full program, you may be dealing with patient enticement. 

Sometimes, scam artists will hack into Google business profiles and change the phone number or links to lead you to a fraudulent call center, where patient brokering or bribery can then occur. This is called listing left. 

Service misrepresentation occurs when a facility advertises credentials or treatment specializations that they don’t actually hold or provide. If you need to ensure that where you’re going has the proper credentials and accommodations, ask to see physical or notarized copies of credentials and certificates that would corroborate services and claims. 

Insurance over-billing and fraud is also a reality. In the cases of over-billing, a treatment center may charge your insurance company for unnecessary drug or urine tests multiple times. In insurance fraud cases, your treatment facility may try to enroll you in insurance plans that utilize false residence statuses to collect rewards from premium policies. You can talk with your current insurance provider to detect this issue. 

Avoid Addiction Treatment Fraud With St. Joseph Institute For Addiction

Our addiction and mental health treatment center is the real deal. We provide all the resources necessary to instill trust and tranquility in our clients along with their families and friends. We’re certified and equipped to treat an array of substance use disorders, both severely advanced and newly developing. We’re available to verify all of our billing and treatment procedures and programs. You can contact us at any time for answers to legal and insurance questions, and we encourage you to bring family, friends, and trusted legal support to appointments and during communications.