Orange County District Attorney Tony Rackauckas recently created a task force to handle abuses in the anti-addiction industry in the “Rehab Riviera.”
Rackauckas is hoping to repeat the success of Palm Beach County State Attorney Dave Aronberg, who created a similar task force two years ago. Since then, Palm Beach officials have made 44 rehab-industry related arrests.
It also has driven many of the rogue rehabs out of that state — and straight to Southern California.
Aronberg recently visited the Southern California News Group, which for the past year has investigated the rehab industry and found evidence of widespread patient brokering, insurance fraud, illegal drug sales and other abuses.
We asked Aronberg – considered a national expert on the rehab problem – about what his office has done to wrangle addiction facilities in Florida, and how that might be adapted to California.
Q: What is the problem with drug treatment facilities in South Florida, and how does it affect us in Orange County?
A: We’ve seen an influx of thousands of young people descend upon South Florida to enter rehab, and then leave only in an ambulance or body bag. Seventy-five percent of all individuals in private pay rehab in Florida come from out of state …. In the past two years, we have led a crackdown on fraud (and) abuse in the drug treatment industry.
We’re seeing an exodus of bad players out of the county to other warm weather climates, including Orange County.
Q: Clients entering rogue rehab facilities tend to fall into a cycle of abuse. Can you describe this cycle?
A: It starts with deceptive marketing; the operator sends a free plane ticket (to the addict), which (in Florida) is a third-degree felony. They lure you down here into a detox or patient recovery center. The individual always has insurance, either on their own or under Affordable Care Act exchanges. If they don’t, the marketer will pay for their insurance and often lie about the address… That’s how the fraud starts.
Now, (clients) get lured down to south Florida. They go through detox, in-patient care (followed by) outpatient care in a sober home, which is an unregulated group home under the protection of the Americans with Disabilities Act and Fair Housing Act. Then, once insurance runs out, they either go home, live with their parents and find a job, or they relapse. And the illegal benefits — such as free rent, transportation and other things — begin anew.
Q: What have you done to fight bad rehabs?
A: We impaneled the grand jury, where we came up with suggestions on how to fix state law. We started a task force where we brought law enforcement from throughout (Palm Beach) county to focus on patient brokering. We worked with the federal government (to) focus on insurance law.
The laws at the federal level are much tougher than state law. They focus on insurance law, we focus on patient brokering. And, together, we have really cleaned up the industry. We have also, as part of our task force,… made 44 arrests. But we’ve also had two other task forces where we brought together people from the league of cities, firefighters, and other local officials and… people within the industry, the good guys within the industry, to come with laws.
Q: What else can be done? And what are the risks for cities that take up the fight?
A: There are two cities in Palm Beach County — Boynton Beach and Delray Beach — that say any new sober home that opens up must be licensed and certified through this voluntary (trade) group, called FARR, Florida Association of Recovery Residences… They monitor their own; they inspect.
We want it mandatory, statewide, but the state refuses to do that. They think it violates the ADA.
Now, whether Boynton Beach and Delray Beach can get away with this effort, we’ll see… It has yet to be challenged in court. Other cities are afraid to follow their lead because they’re worried about getting sued and losing. Boca Raton lost and had to pay $3 million.
Q: What still needs to be addressed?
One glaring area, that we have been largely unable to get at, is the issue of sober living homes.
Because they don’t offer treatment, sober living homes are not licensed or regulated under state or federal law. And any attempt at a local level to certify or inspect sober living homes can be met with opposition through lawsuits connected to the Americans with Disabilities Act.
So, until the federal government clarifies the ADA to allow local governments to enact reasonable measures for the health, safety and welfare of individuals residing in sober homes, local governments will continue fighting with one hand tied behind their backs.
Q: How can Southern California adapt the anti-fraud rehab steps you’ve taken in Florida?
A: First, you have to have sensible laws at the state level. Right now, California doesn’t have an anti-patient brokering act; an anti-kickback act. That’s why you have so many sober living homes.
In Florida, (some anti-kickback laws) had been on the books for years. But when we changed the laws, we updated our patient brokering act to get tough and make it a felony… When we started this, it took 13 counts to qualify the person for prison time. It’s inviting the criminal element to invade your community when you don’t penalize kickbacks; health care kickbacks.
You don’t penalize (in California). So, you open up a sober home, the sober home charges zero rent (to clients) and the operator gets a kickback from the treatment facility down the street.
And you wonder why so many sober homes are popping up?
When Orange County cracks down on this, you’ll see the problem (shift outside of the county) and it will become a statewide concern.
Q: What should be done at the federal level?
A: If I could change the laws and help change this problem, I would change the reimbursement model for the Affordable Care Act. It’s a fee-for-service model. So, right now, the more you (the operator) fail the more money you get.
Q: Can you summarize the solutions?
A: I would suggest impaneling a grand jury to look at the issue. It gives it a local flavor. And I think that’s important. It also gives political strength behind your legislation.
In the meantime, enact a tough anti-patient brokering law at the state level.
Number three, lobby Congress to allow local governments to enact reasonable measures. In the meantime, consider following the leads of Prescott, AZ., Delray Beach and Boynton Beach, who are out sticking their necks out (with local ordinances).”
View the original article here.