posted by AHIP
on October 25, 2018
Untreated substance use disorders (SUD) have a significant impact on individuals, families, communities, our economy, and society. In the past year alone, 20.1 million Americans suffered from a substance use disorder with more than 2 million addicted to opioids.1 Substance use and addiction, including use of alcohol and illicit drugs and the misuse of prescription drugs, is estimated to account for more than $740 billion annually in costs related to crime, lost productivity, and health care.2 On an average day, at least 78 people will die from an opioid-related overdose, 3,900 people will use a prescription opioid outside of legitimate medical purposes, and 580 people will try heroin for the first time.3
The opioid crisis has led to a pressing need for quality, evidence-based treatment options to keep pace with the growing number of individuals suffering with opioid and other substance use disorders. Yet fraudulent practices threaten to undermine efforts to provide access to quality, accredited treatment facilities. For example, there is growing concern over “body brokers” who target and exploit vulnerable individuals and steer them – through deceptive advertising and marketing practices – to substandard recovery or sober homes. These substandard homes are associated with clinicians or treatment centers that may not provide evidence-based addiction treatment, frequently bill for excessive or unnecessary tests, and may fraudulently bill multiple insurers for a single patient’s services.4 This has the potential to harm patients who are at a vulnerable stage of treatment and recovery.
Policymakers and stakeholders must work together to address these fraudulent practices and protect patients from substandard and potentially harmful care received through these arrangements.