The congressional representatives sitting on the House Subcommittee on Oversight and Investigations wanted to hear about patient brokering and sober home fraud.
Tuesday morning, they got an earful from Palm Beach County State Attorney Dave Aronberg and his chief assistant, Al Johnson.
“We have had a surge of unscrupulous individuals who prey on addicts,” said Aronberg. “Everyone is getting rich” — telemarketers, sober home owners, labs.
“This is the Florida shuffle,” he said, a system built to create a recurring relapse so that the insurance payment clock can be reset. “This is a relapse model. Not a recovery model.”
You can find their testimony, five minutes each, around 29:00 (Aronberg) and 34:08 (Johnson).
Tuesday’s hearing on treatment fraud comes on the heels of letters sent in November to the top substance abuse officials in half a dozen states, including Florida, asking for information on how they were handling patient brokering.
Citing coverage by The Palm Beach Post and other media outlets, those letters were triggered by the U.S. Department of Health and Human Services’ response to the committee’s first inquiry this summer about oversight of patient brokering.
The federal health agency’s answer: Every state does it differently.
Florida’s Department of Children and Families, which oversees substance abuse in Florida, replied that it had closed just five bogus sober homes in the past year.
Yet Aronberg’s office has arrested 41 people linked to sober home fraud in the past year in Palm Beach County alone involving seven sober home and addiction treatment facilities.
Joining Aronberg and Johnson were Eric Gold, office of the Massachusetts attorney general; Pete Nielsen, chief executive of the California Consortium of Addiction Programs and Professionals; and Douglas Tieman, CEO of Caron Treatment Centers, which is based in South Florida and Pennsylvania.
All, said U.S. Rep. Greg Harper, are “on the front lines of this issue.”
Oversight of rogue operators has been stymied by federal law designed to protect patients from discrimination, said Aronberg, including the Americans With Disabilities Act and the Fair Housing Act. For instance, Florida lawmakers won’t make certification of sober homes mandatory because they are afraid of running afoul of those acts.
The same concerns have slowed efforts by Palm Beach County cities from enacting oversight and regulations, Aronberg said. He suggested Congress clarify the laws to allow more regulation.
Long the nation’s addiction treatment capital, Palm Beach County also has emerged as a hotbed of sober home fraud.
Sober homes are houses where people looking to recover in a sober environment live together. That’s the goal.
The reality, Aronberg told the subcommittee, is that the majority of sober homes in this county are little more than flophouses. Drug use in such homes may be common.
The results can be tragic.
In 2016, Palm Beach County Fire Rescue alone responded to 4,661 opioid overdoses, said Johnson, and 552 of them were fatal. “Many, if not most of the calls, were to sober homes,” he said.
Take Casey McRae, a young mother who traveled from Texas to stay in a Palm Beach County sober home with a friend. McCrae, 20, had no known history of drug abuse. Within a month, she tried heroin provided by a resident of the sober home for the first time, overdosed and died.
But not before her insurance company had been billed for more than $30,000 in urine drug tests, said her family.
Subcommittee members appeared shocked by testimony about those costs. A single urine test could net as much as $3,000, and some people have been tested daily.
And it’s not just Florida. Sober home fraud and patient abuses are now endemic across the country, said B.K. McDonough, government affairs specialist with Caron.
That’s why federal help is needed, she said.
But, said Aronberg, “We can’t do it alone.”