In the last year, several reporters have taken note of the return to “predatory” practices used to recruit addicts for treatment, normally in Florida treatment centers, such as targeting Illinois residents. The tactics are all quite legal, but not in the benefit of the consumer. The full article, by Alison Knopf, is much more detailed and worth a read.
Among the most profitable tactic is to have no In-Network coverage; essentially, this allows for an unlimited charge. The insurance company takes part of it (normally 50% or so), and in theory the consumer is responsible for the other half – but just receiving the insurance company’s half is more than an In-Network full payment. As noted by Gerald “Jud” E. DeLoss, (outside legal counsel for the Illinois Alcoholism and Drug Dependence Association), this practice is normally made illegal, seen as a kick-back, but, “[i]t is possible to structure such an arrangement legally but it is complex and an unsettled area of the law.”
Peter Palanca, on the board for the National Association of Addiction Treatment Providers (NAATP), notes the public is largely uneducated about recovery, and generally scared when asked to help find treatment for a loved one. And, the number of people who have to help a family member find care is rapidly growing.
The combination of these two elements means substandard care can be purchased for premium rates. Ultimately, this doesn’t benefit the addict (who needs a proper level of care), or the insurance companies (who respond in several ways to try and control costs, ultimately punishing the consumer).
The sad reality is, in many cases, the rehab centers who fill their beds by over-promising and under-delivering are the only winners.
The recommendations to guards against this are pretty simple – look for reputable businesses, with licenses to treat physical and/or mental addictions, and ask which insurances carries have In-Network coverage.