What Is Patient Brokering?

What is Patient Brokering?

It is a privilege and a responsibility to be a part of someone’s addiction recovery. Most substance abuse treatment providers take this responsibility seriously and are dedicated to the recovery of their patients and their patients’ families. Unfortunately, there is a sector of treatment providers whose quest for profits outweighs the trust of people and families in crisis.

How Does Patient Brokering Work?

Patient brokering is an unethical practice that preys on people who need addiction treatment. Patient brokers appear to want to get their targets the help they need, but their actions can be harmful to people who get caught as pawns in this scheme.

Patient brokering trades a client to a treatment program in return for money, perks or other compensation from that treatment center. In some cases, a broker will contact a treatment program or sober home with a prospective client and solicit a kickback or commission or charge a fee in exchange for the client’s information.

Patient brokers may offer to pay travel expenses to get potential clients to the treatment center. They may even infiltrate treatment programs and provide drugs or cash to other clients to buy drugs, triggering a relapse that starts the treatment cycle over again.

Another example is a program or sober home recruiting individuals, their own patients, or other programs to send them patients in return for a kickback or fee. No matter who participates in this type of transaction, it’s illegal and it is also a form of human trafficking.

Financial Motivation

People who have insurance that covers drug and alcohol abuse treatment are the primary targets of patient brokering. Unethical treatment centers are willing to pay patient brokers because a single client with good insurance can be worth tens of thousands of dollars in insurance claims.

The Affordable Care Act mandates the inclusion of addiction treatment and mental healthcare coverage in insurance plans. Since the Affordable Care Act was implemented in 2010, patient brokering has spread across the U.S., because more people have insurance coverage for substance abuse treatment than ever before.

Substance abuse treatment spending is expected to rise from $24 billion in 2009 to $42 billion in 2020. Treatment providers are competing in a highly lucrative market where there are billions of dollars to be made. While reputable treatment centers emphasize the quality of their treatment and success stories to attract patients, some use underhanded tactics such as patient brokering to pad their profits.

How Can You Avoid Patient Brokering?

Be wary of settings where patient brokers like to find targets. These brokers troll AA meetings, detox and rehab facilities as well as locations where drug use is known to take place.

A reputable treatment center will make sure the individual is a good fit for their program. This means an initial screening and comprehensive assessment will be performed before admission to the program. Also, depending on the type of program, the essential standards of addiction treatment should be available such as withdrawal management, treatment planning and management, treatment transitions, and comprehensive aftercare.

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