The New Jersey State Commission of Investigation last week said some addiction treatment center operators and recovery industry employees engaged in “appalling and in certain instances potentially unlawful practices” to keep people at their facilities for insurance-paid stays.
At a hearing in Trenton to highlight the flaws in the addiction rehabilitation industry, commission investigators testified about their work and what they found as they looked into practices dating back to 2018. The allegations ranged from extensively billing insurance companies to skirting laws regarding patient brokering.
“Some manipulate drug tests or keep patients in the most intensive level of treatment — even if no longer necessary — for prolonged periods,” SCI Chair Tiffany Williams Brewer said. “The result here is that despite advertised claims that they’re in the business to help people trying to overcome addiction issues, numerous recovery facilities and professionals in this state are not looking out for patients’ best interests. Instead, they’re looking to enrich themselves and their corporate interests.”
Investigators said the nonprofit organization Recovery Advocates of America, which is based in Hamilton, has referred patients to treatment centers and bought airline tickets for treatment centers that donate to the organization.
The findings for Kingsway Treatment Center were even more damning. Money from insurance companies charged for treatment didn’t go to further helping clients in the program but rather into the pockets of the owners.
Kingsway owner Nicholas DeSimone was subpoenaed to appear at the hearing. He filed a motion to quash that subpoena and was not present at the hearing. DeSimone's attorney Gilbert Brooks said in an email that "Mr. DeSimone has no comment" besides what has been filed with the court.
Thomas Wilson, a spokesperson for Horizon Blue Cross Blue Shield of New Jersey, the state's largest insurer, applauded the commission "for shining a bright light on this problem.”
“There are many excellent treatment providers right here in New Jersey and elsewhere that follow evidence-based treatment programs, but there are also too many eager to prey on people when they are desperate for help and hope,” he said.
“It is critical that we identify and root out the bad actors, but it is also essential that we recognize the providers who have joined us so far in sending a clear message that we are united here in New Jersey in our commitment to evidence-based treatment and to giving people meaningful information that helps them choose the right program and treatment partner,” Wilson said.
Anonymous testimony from recovery clients highlighted wrongdoing by recovery coaches and employees at the facilities. They were encouraged to drink or use drugs to ensure that they could gain admittance into recovery programs.
“This is not information that has been compiled before in the manner it was,” Brewer said. “This is important because these are average, everyday citizens going through a health crisis and a family crisis, and what happens next in the addiction recovery industry could mean the difference between life and death.”
The commission is expected to release a report in the next few months highlighting ways to improve the system and make it less prone to abuse.
From northjersey.com
