How to Choose an Ethical Treatment Center

By The Fix staff 08/16/17

Be careful when searching for addiction treatment: many websites, ads and phone numbers are designed to look like helplines when they are actually just funneling patients to a specific treatment center.

Hazelden’s Naples, Florida facility: a white building with balconies and a lot of glass, surrounded by palm trees.
Hazelden’s Naples, Florida facility

When a person decides to seek treatment for addiction, time is of the essence. The person needs to find a treatment center that has openings, accepts their insurance and meets their needs, all before they lose the nerve to get help. If anything goes wrong in the process, the consequences could be deadly.

“I often describe it as the most complex decision someone has to make in their lifetime,” says Bob Poznanovich, the executive director of Business Development for the Hazelden Betty Ford Foundation. “You’re asking them in moment of crisis to make their largest financial, health and career decision they have ever made when they’ve never bought this product or service before and probably don’t know anyone who has. You’re asking them to make that decision sight unseen over the phone on blind faith, when they may be impaired. I can’t think of a more vulnerable environment.”

The vulnerability and desperation that many people feel when picking a treatment center has given rise to a culture of unethical practices in the addiction treatment industry, some say.

“There is a plethora of ethically or even legally questionable clinical and business practices that have become all too common in this industry,” Poznanovich says.

While shady business practices happen in recovery centers across the country, Florida has made the most headlines. In 2015, the insurance company Cigna announced that it wouldn’t offer policies in the state because of a booming recovery industry known for ripping off insurance companies. More recently sober homes have been accused of taking kickbacks and a Florida doctor was recently sentenced to ten years in federal prison for his part in a sober home fraud scheme.

Poznanovich says that stories like this stem from a culture in which individuals and companies seek to profit off people struggling with addiction.

“This really started with the whole gold rush when we saw the addiction rates rise. The demand increased because more people were sick,” he says. “That gave the perfect opportunity because there was more demand and more people with access to treatment because of insurance coverage, so the dollars were there.”

One of the most common unethical practices in the treatment industry is patient brokering, where a third party receives money for sending a pre-qualified patient to a treatment center. Poznanovich says that people seeking help often call these third-party businesses, which are marketed to look like help lines, not realizing that they are operating for profit and receiving between $1,000 and $7,000 per patient that they refer. Although some states, including Florida, now have laws against patient brokering, the practice remains relatively common.

Treatment centers have also been known to charge high amounts for drug testing or order more drug testing than is need or covered by insurance.

“I’ve seen examples of facilities sending $1,200 bills for $5 tests,” Poznanovich says.

Other schemes, he added “will just make you shake your head.” Treatment centers have been caught incentivizing patients to stay in treatment (so the center can continue billing insurance), or even paying people to relapse in order to return to treatment.

However, not all unethical practices are so egregious. Even offering free flights to treatment should raise a red flag, Poznanovich says.

“Consumers would view this as a great deal, when really there’s no such thing as a free lunch,” he says. “Buyer beware: if it sounds too good, it might be.”

Enticing offers might indicate that a treatment center is focused more on attracting clients than on providing a high level of care.

“Ask yourself can they provide the quality of care if they’re providing the free deals,” Poznanovich says. “Where are they skimping and what might [patients] be at risk for?”

Of course all of this makes it difficult for people to find quality help when they need it most. Poznanovich recommends that whenever possible people seeking care have a loved one help them through the process. They should not be afraid to ask questions about a treatment center’s policies, and to confirm separately with their insurance companies what their coverage will be. Treatment centers that are accredited through the Joint Commission have undergone some screening and are a good option.

When initially searching for a treatment center, it’s important to realize that many websites, ads and phone numbers are designed to look like helplines when they are actually just funneling patients to a specific treatment center.

While there has been some attention paid to unethical treatment practices, Poznanovich says it often falls on the client to protect themselves from predatory treatment centers and to seek treatment centers with strong ethical guidelines.

“I think those who have always been ethical and have strong business and ethical guidelines will remain stronger,” he says. However, that is often an unpopular stance, at least initially.

“We don’t fly patients in or waive copays and deductibles,” says Poznanovich, who has had potential clients hang up when they realize that the Hazelden Betty Ford Foundation does not offer deals that some other treatment centers promote, or make promises about insurance coverage that they cannot guarantee.

“It affects the Hazelden Betty Ford Foundation because we’re very concerned about how we treat patients. The ethical guidelines we follow are to a T, and our marketing outreach tactics are upfront and ethical. But we’re compared to those who aren’t.”

Get more information on the Hazelden Betty Ford Foundation here, and connect with the organization on Facebook.

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