Dear Gov. Newsom: Thanks for the new laws. Thanks for the new inspectors. Thanks, I guess, for trying, even a little.
But — and isn’t there always a but? — it’s not working. And it’s maddening that the fraud and abuse still plaguing California’s addiction treatment industry aren’t being exposed by California’s regulators, or California’s attorney general, or its district attorneys or insurance commissioner, but by the federal Department of Justice and the insurance companies footing the bills. To wit:
Last month, Aetna filed a lawsuit against a slew of rehabs and their operators in Orange, Los Angeles and Riverside counties, claiming fraud, negligent misrepresentation, economic interference, conspiracy under the Racketeer Influenced and Corrupt Organizations Act and unjust enrichment.
“The various schemes perpetrated by Defendants here are particularly disturbing,” the Aetna suit says. “Since at least 2021, Defendants have targeted vulnerable Aetna members who suffer from alcohol and/or substance dependency issues as part of a concerted effort to profit at their expense. Defendants used the patients for health benefit payments under the lie of helping them, while doing the exact opposite.
“Defendants lured patients into their programs by offering them kickbacks in the form of … free or low-cost living arrangements in ‘sober living homes’ located in highly desirable locations throughout California. In reality, the sober living homes were little more than drug dens, used to ensure patients remained in Defendants’ treatment ‘programs’ for as long as possible…. ensuring reliance on treatment rather than recovery from treatment.”
In the rare instance where a patient progressed while still retaining benefits, Aetna said the operators encouraged drug use so the treatment cycle (and billings) could start anew.
“Defendants weaponized addiction and pushed relapse to prevent recovery,” the suit says. “Far from performing…
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