Addiction Providers Look To Alter The Industry's Growing Reputation For Fraud

Yeah. Big Surprise. In which Alternate Universe?

fiercehealthcare

Bad actors forcing some payers to take hard stance on reimbursement

February 23, 2016 | By Evan Sweeney

Providers who specialize in addiction services are scrambling to rehabilitate the industry's image following high-profile fraud cases that have caught the attention of federal regulators and private insurers, according to the Palm Beach Post.

The addiction treatment industry has been marred by multi-million dollar cases, including a well-publicized federal investigation into expensive urine testing claims submitted Millennium Health that culminated in a $256 million settlement. Last year, Cigna announced it was pulling out of the Florida marketplace, citing an increase of fraudulent addiction treatment claims, according to the Post.

At a recent addiction treatment conference in Naples, Florida, Doug Nemecek, M.D., chief medical officer of Cigna's behavioral heath division, indicated Cigna is steering beneficiaries toward in-network providers, and is considering other measures that would minimize the threat of fraudulent claims, such as refusing coverage for out-of-network providers and dropping out-of-area benefits, according to the Post.

On the provider side, the American Society of Addiction Medicine is planning to release new clinical guidelines for urine testing, while others believe self-policing is the key to ushering bad actors out of the system.

Legal experts have said health payers are aggressively investigating addiction treatment services in 2016 with additional requests for medical and billing records. Last year, the father and son owners of Narco Freedom, a drug treatment company based in New York City, were indicted on charges of fraud and money laundering. Months later, a New York Times investigation outlined an ongoing Medicaid scheme involving three-quarter houses throughout the city.

To learn more:
- read the Palm Beach Post article

Related Articles:
Fraudulent Medicaid claims filed through drug treatment centers fund lavish purchases
New York City's unregulated 'three-quarter houses' ripe with Medicaid fraud
Millennium Health faces more legal backlash for unnecessary drug tests
How a healthcare CEO committed fraud and walked away a richer man
Payers are ramping up addiction treatment audits

Thank You Mr Sweeny and FHP AF.

If you didn't click on our 'Alternate Universe' link at the top of the page.

Alcoholics Anonymous: Another Colossal Behaviorist Fraud/FAILURE

"AA’s actual success rate somewhere between 5 and 8 percent."

Without delving into the mathematics of statistics, in street lingo, a coin toss is 50 percent. 5 to 8 percent? 

Of course it's a fraud, and Alcohol and Drug Treatment Centers Know its a fraud. There's no way they can't know its a fraud with all the insurers and customers they sucker out of 4, 5, and sometimes 6 figures to defraud them, all day, every day.

Sell them a room, feed them canned beef stew and cheerios in place of intoxicants, and patronize them with behaviorism's humanist dictum that the Only Road To Recovery starts with YOU, Mr/s Sucker abasing themselves into admitting before the other suckers, that they have a Disease, which the sales force Invented, in order to take their Money.

A success rate of 5 to 8 percent virtually guarantees the consumer will return to their addiction of choice, and then return to the addiction-ologists for another week or month of canned beef stew, cheerios and behaviorist BS at thousands of dollars a day, to be yet again shuffled back off to AA, NA, or whatever A for yet a 3rd pant load of FAIL.

And the Addiction Industry's reputation for Fraud is growing?

Thank You Again Mr Sweeny, for continuing to document it at FHP AF. 

We are now $19 Trillion in debt. 

Turn off the OPM spigot.