If you have a family member or friend struggling with an addiction, you want them to receive the best treatment possible. But if that person is young, insured and seeking treatment outside of Illinois, beware of providers offering false promises of hope.
NBC 5 Investigates interviewed parents and behavioral health advocates and spoke to a leading insurance industry group to unravel a rehab scheme that is costing everyone money and possibly even taking lives.
“It’s absolutely a scam,” said Jeanette, a concerned parent from suburban St. Charles.
Jeanette said her 19-year-old daughter grew up loving softball and cheerleading, but as a teenager she developed a drug addiction. While her daughter is currently in Los Angeles receiving treatment in an intense outpatient program, Jeanette said her daughter bounced from one treatment facility to the next.
“She was thrown out of a sober house. Within hours she was in a new sober house. And then she was out of that one and then in to another one,” Jeanette said.
According to Jeanette, her daughter was being paid money to relapse and start the treatment process over again.
“She got taken out to nice dinners almost every night. She got clothes bought for her,” Jeanette said.
Sara Howe of the Illinois Association of Behavioral Health said young, insured adults from Illinois are being lured to unscrupulous treatment centers or sober living group homes. She said so-called patient brokers may find an addict at an AA or NA meeting and convince them to travel to Florida or California for their treatment.
“Once you get there, they often don’t look like what you see on the website,” Howe said. “They’re not beach-front property. They’re sometimes miles from the beach. They don’t have licensed staff.”
Howe said the some of treatment facilities are billing insurance companies millions of dollars for unnecessary or sub-standard care.
“Somebody’s got to pay for that. The bottom line is where is that gonna go? Well, it’s gonna go to your premiums,” Howe said.
But for local families struggling with addiction, the promise of recovery on beach-front property may sound like a solution.
Jennifer Flory of Sugar Grove said her daughter, Alison, received good treatment in Florida for her drug addiction until she met a broker at an “AA” meeting.
“They enticed her with different offers of a better experience, free cigarettes, free rent, stuff like that, co-ed living,” Flory said.
Flory said her daughter shuffled between treatment centers and sober living group homes for more than a year while the family’s insurance was billed more than one million dollars.
“It was almost as if they needed to do the drug in order to get the benefits of treatment,” Flory said.
Sadly, Alison passed away in 2016 due to a drug overdose at her sober home.
“It’s an everyday thing that you think about what could I have done differently? Why’d this happen to me?” Flory said.
Industry group American Health Insurance Plans said insurance providers are extremely concerned about “body brokers” who target and exploit vulnerable individuals by targeting insurance companies to bill for treatment and tests that may or may not be clinically appropriate or actually even be provided.
“These fraudulent, abusive practices not only put patients’ lives in grave danger, but they also make it more difficult for people to afford their coverage and care,” said an AHIP spokesperson. “These practices raise overall health system costs and increase premiums for everyone, not just those who are sent to ‘sober homes’.”
Howe said while there are plenty of good treatment centers across the country, Illinois families don’t have to send their loved ones out of state.
Tim Ryan is a Naperville-based activist against heroin who said Illinois has some good treatment facilities, but sometimes it’s beneficial to leave the state.
“Sometimes you need to get people away from their environment,” Ryan said.
But Ryan urges addicts and their family members to be on the lookout for patient brokers who troll Chicago area AA meetings.
“A lot of these people that work for these centers have never been there,” Ryan said. “Ask the patient brokers how they’re paid. A legit treatment center will only hire a salaried employee.”
Lawmakers in Illinois are considering a proposed law, HB 4949, that would make it illegal for brokers to lure patients out-of-state under false promises, especially if the facility is understaffed and unlicensed.
Meanwhile, Jeanette said she feels like she’s teetering on an edge as she waits to receive updates from her daughter.
“The moments that I know she’s safe and I know where she is and what’s happening, I can function a lot better,” Jeanette said.