insurance fraud Archives -
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Dave Aronberg Talks How to Fight Fraud in Treatment Industry

Dave Aronberg Talks How to Fight Fraud in Treatment Industry

8 months ago, Florida was home to 953 licensed drug treatment centers, and 207 were in Palm Beach County. As of April 1, there are now 185 in Palm Beach, with 771 in the whole state. This decrease is due to the crackdown on fraud by Palm Beach State Attorney’s Office, which has led to 45 arrests in the last year and a half. So far, those arrests have led to 16 convictions. For State Attorney Dave Aronberg there is no sign of slowing down.

Recently, Dave Aronberg spoke with Opioid Watch to talk about the work his office has been doing to try and strengthen the addiction treatment industry. Chief Assistant State Attorney Alan Johnson also sat down to talk about how Palm Beach County is fighting to protect those who are coming to Florida for help. Johnson heads the office’s Sober Homes Task Force.

Dave Aronberg VS Purdue Pharma

 According to Aronberg, he got involved with opioid-related issues back in 2001, when he was an assistant attorney general. Aronberg says he was asked by his boss, Bob Butterworth, to investigate Purdue Pharma. This Big Pharma giant is the producer of OxyContin. This powerful prescription opioid has been credited with making a heavy contribution to the opioid crisis. Dave Aronberg was to examine the marketing practices of Purdue Pharma, and is quoted in the interview transcript stating:

“I believe we were one of the first in the country.”

Of course, now Purdue Pharma is one of many big name pharmaceutical companies being accused in lawsuits across America. In fact, Delray Beach, Florida recently filed its own case against the company.

When asked about what he found, Aronberg said that Purdue was marketing the product like it was Advil. Purdue has been repeatedly accused of pushing this product as if it was far less dangerous than it actually was. In 2002, Dave Aronberg was elected to state senate, and shortly afterward the case against Purdue was settled. In the edited interview transcript, Aronberg is quoted:

“Purdue also offered $2 million to the state to establish its first prescription drug monitoring program. I worked in the state senate to get the PDMP enacted into law. But some conservatives refused to go along. They thought it was Big Government. So Purdue’s $2 million went away, because the offer expired. We didn’t get the PDMP till 2011. By then the carnage was horrific.”

Furthermore, Opioid Watch notes that a Purdue spokesperson confirmed that the state failed to implement a PDMP by July 1, 2004, which was the expiration of the companies offer.

Dave Aronberg Goes to Congress

In December of 2017, Aronberg went in front of Congress to testify concerning fraud and abuse in the addiction treatment industry. In this meeting, they discussed various issues with shady facility operators in Florida and made suggestions on how the law could step in to change it and protect patients. The interview transcript quotes Aronberg:

“In recent years, we’ve had an influx of unscrupulous operators who enrich themselves by exploiting those in recovery. As a consequence, we’re attracting thousands of young people from throughout the country into fraudulent rehab centers. (We’re talking about some, not all. There are good rehab centers, too.)”

Again, Aronberg found himself at battle with shady marketing practices. While investigating the treatment industry, Aronberg’s office discovered illegal operations that not only manipulated insurance providers but put patients at extreme risk.

From patient brokering, where illicit actors would sell patients with insurance to the highest bidders, to illegal kickback schemes being run by sober homes to outpatient treatment programs. Chief Assistant State Attorney Alan Johnson added information about the exploitation of urine analysis costs, and even some programs that began billing insurers for allergy and DNA testing. Aronberg states:

“We have a doctor who billed $7 million in nine months for allergy tests.”

Needless to say, the task force and state officials had their work cut out for them.

The ACA, ADA, and FHA

When talking about the many scams being run by various illegitimate businesses, the conversation came back to insurance and how these cons run. Here Dave Aronberg talks about his beliefs on how the law should step in and help restructure the current system.

“Number one: Change the Affordable Care Act’s fee reimbursement model to an outcome-based reimbursement model. Where the good providers are rewarded and the bad ones are paid less. Right now, the opposite occurs, so the more times you fail, the more money you get. There’s an incentive for more services and for more relapse. That shouldn’t be.”

After talking about the issues with the ACA, he talked about the ADA and FHA.

“The second change we need is this: the Americans with Disabilities Act and Federal Housing Act have been misused and exploited by bad actors who own flophouses.”

He went on to say,

  “Local governments are largely prohibited from overseeing the sober home industry. If they want to require mandatory inspections, certifications, and registrations, they’re likely prohibited under federal law.”

In essence, Aronberg believes the law should allow local governments to create their own guidelines for health, safety and the general welfare of the patients. None of these demands seems outlandish, and with reasonable regulation, the reputable and effective providers in this industry can continue to best serve the South Florida recovery community.

Aronberg also points out that the problem is not only in Florida. Recently, he went to Orange County, California to meet with officials dealing with the same situation. Next for Dave Aronberg is leading the national task force of 34 prosecutors in 30 states. Their goal is to produce a working paper for setting best practices for prosecutors all over America concerning these issues. The task force also intends to make suggestions for changes to federal and state laws.

What might be most surprising though is the mention of harm reduction strategies?

“It’s about prevention, drug treatment, and innovative strategies. I think it will be powerful because it’s going to be prosecutors talking about needle exchanges and disposal and safe injection sites. People assume prosecutors are going to be focusing only on mandatory minimums and longer sentences. That’s not what this is about. I think it’s going to surprise people.”

While needle exchanges and safe injection sites have been proposed in numerous states, it is not the most popular idea. San Francisco is actually on track to open the first safe injection site in America, with Philadelphia not far behind, and Seattle and Baltimore in the conversation as well.

With Aronberg and the task force working to make a difference, hopefully, we will see the right change soon. We hope it will make the recovery community stronger as a whole. Reputable and respected providers are also doing their part to refine their practices while implementing innovative and effective resources to ensure that those who with drug or alcohol addiction always have a safe place in Palm Beach County to get the help they need. With the opioid crisis ongoing, having real resources for opioid treatment is still an essential part of overcoming the problem.

Palm Healthcare Company is a leader in holistic addiction treatment with over 20 years of helping people from all over the country heal mind, body and spirit. Providing safe and comprehensive care should always be a focus in the effort to overcome the drug problem, and preservation of life should always be a priority. If you or someone you love is struggling, please call toll-free now.

CALL NOW 1-888-922-5398

Racketeering for Fentanyl: Opioid Maker Insys Founder Arrested for Bribes

Big Pharma Founder of Insys Arrested on Racketeering for Fentanyl

In December of 2016, the Palm Partners Recovery Center blog covered a story about how federal prosecutors were bringing racketeering charges against several employees of Insys Therapeutics Inc. The initial report and the controversy that followed was a profound moment considering criminal charges are rarely ever brought against pharmaceutical companies. Now it seems that even more the corporate drug dealers who helped create the opioid crisis in America are going to be finding themselves under serious scrutiny for their unethical practices.

Last week President Trump declared the opioid epidemic a public health emergency. That very same day, as if to accent the severity of the crisis and the unignorable need for change, the co-founder of Insys Therapeutics Inc. himself was arrested on fraud and racketeering charges.

Insys Therapeutics CEO Taking a Fall

John Kapoor is the former CEO of Insys Therapeutics; a founding father of one of the most prominent opioid manufacturing companies in America. As of last week, Kapoor is reported to be charged with conspiring to push the company’s signature drug for unacceptable uses through a series of bribes and kickbacks.

The drug Kapoor and his company are accused of pushing just happens to be one of the most dangerous opioids on the market, which has contributed to countless deaths across the country over the years- fentanyl.

The brand name for the product made by Insys Therapeutics Inc is Subsys. This extremely potent compound transmits the synthetic opioid fentanyl in spray form. As an opioid analgesic, people use Subsys by spraying it under the tongue for quick absorption of potent fentanyl. Technically, this drug is supposed to only be used for treating cancer patients suffering from severe pain. But according to prosecutors that is very far from the sales strategy Kapoor and his executives were using.

With recent reports showing that approximately 64,000 Americans died last year from drug overdose, and an estimated 20,100 overdose deaths linked to synthetic opioids like fentanyl, how many of those lives were impacted by the drug Insys forced onto the market with bribes?

According to the prosecution, Kapoor and several other former high-ranking executives at the company colluded to bribe doctors to write-

“- large numbers of prescriptions for the patients, most of whom were not diagnosed with cancer.”

They also allegedly-

“- conspired to mislead and defraud health insurance providers who were reluctant to approve payment for the drug when it was prescribed for non-cancer patients.”

How did they do all this?

The Insidious Work of  Insys Therapeutics Inc

Back in 2016, there was the discussion of six former executives and sales-managers from Insys Therapeutics Inc. being arrested. The charges, according to the Justice Department, included:

  • Conspiring to defraud health insurers
  • Conspiring to bribe doctors into needlessly prescribing Subsys, the company’s fentanyl painkiller

The scam is allegedly a long list of kickback schemes, sham speaking programs, and illegitimate gifts or services.

Sham Speaking

Allegedly, doctors and nurses were paid to attend dinners at high-end restaurants. These dinners were disguised as ‘speaker programs’ that were actually described as gatherings of friends and co-workers who had no power to prescribe medications. Supposed ‘speakers’ were paid fees of up to several thousand dollars for attending these exclusive outings.

One healthcare provider reportedly received an illegal kickback to the tune of $83,000!

All of this money to bribe doctors and other healthcare professionals to prescribe Subsys, even when inappropriate. So not only were they pressuring doctors to use their product over alternatives, but also to prescribe a dangerous and potentially fatal opioid to people who didn’t even need it.

Country-Wide Con-Artists

Other stories written about in Forbes include cases in:

  • Connecticut

In 2015 a nurse practitioner pleaded guilty to violating a federal anti-kickback statute by taking money from Insys to prescribe the drug to Medicare patients who did not have cancer.

  • Alabama

A former Insys sales representative also pleaded guilty to a conspiracy to violate the anti-kickback statute by paying two doctors to prescribe the drug.

  • Illinois

The state has filed multiple claims against Insys Therapeutics involving the pressuring prescriptions of Subsys for unapproved uses.

Doctors who have worked with the company are being investigated by states including:

  • New York

  • Michigan

  • Florida

  • Kansas

  • New Hampshire

  • Rhode Island

U.S. attorneys in the Central District of California and the District of Massachusetts are also investigating Insys Therapeutics Inc.

Shady Gifts and Services

The buck doesn’t stop there either. It wasn’t just cash gifts for unethical practices. Insys Therapeutics wanted their partners in crime to get the full effect of their illicit activities.

The company would send its own employees to work in doctor’s offices when the physician prescribed their fentanyl fuming drug to patients. They even hired the relatives of health care providers as a favor to the family for their loyalty to Subsys.

Insurance Fraud

They allegedly even set up a portion of their staff to defraud insurance companies by calling to speak with insurance representatives while posing as doctors. Some allegations state they were even misrepresenting a patients diagnosis to inflate drug sales.

A December of 2016 indictment states that Insys actively worked to defraud insurance companies by setting up the “reimbursement unit” dedicated to obtaining prior authorization from insurers and pharmacy benefit managers.

Other Insys Therapeutics Exes

Kapoor stepped down as chief executive in January. However, he is definitely not the only former Insys Therapeutics executive currently under fire. This is just the tip of a very rocky ice-berg. The indictment from 2016 included:

  1. Michael L. Babich

Former CEO and President of the company from Scottsdale, Arizona

  1. Alec Burlakoff

Former Vice President of Sales from Charlotte, North Carolina

  1. Richard M. Simon

Former National Director of Sales from Seal Beach, California

  1. Sunrise Lee

Former Regional Sales Director from Bryant City, Michigan

  1. Joseph A. Rowan

Former Regional Sales Director from Panama City, Florida

  1. Michael J. Gurry

Former Vice President of Managed Markets from Scottsdale, Arizona

On January 5, 2017, all of these defendants appeared in federal court for their initial appearance and arraignment. Each has pled not guilty and been released on conditions approved by the court.  A Status Conference hearing followed on September 12, 2017 that is the first of many to be held over several months. That day Massachusetts federal judge set a trial date for October 15, 2018, for the 6 executives.

For now, we have to wait and see if any of the dirty laundries from these alleged white-collar criminals come out in the wash.

Holding Big Pharma Accountable

For a long time, Big Pharma companies have been using unlawful and corrupt tactics for marketing and distribution, which many now see has brought with it some great devastation to communities across the nation. Now, during an opioid crisis that has claimed tens of thousands of lives a year, for several years, these discretions are finally catching up to those accused of corporate greed. The DEA, FBI and Justice Department, along with several state officials and district attorneys, are now aggressively pursuing charges against Big Pharma operators who have a connection to some of the most dangerous and widely abused narcotics on the market.

The acting U.S. Attorney William D. Weinreb said in a statement,

“In the midst of a nationwide opioid epidemic that has reached crisis proportions, Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit.

“Today’s arrest and charges reflect our ongoing efforts to attack the opioid crisis from all angles,”

Kapoor was arrested in Arizona and his indictment was filed in federal court in Boston. Prosecutors say the charge of conspiracy to violate the anti-kickback law carries the possibility of up to five years in prison. However, the charges of conspiracy to commit racketeering and conspiracy to commit mail and wire fraud each carry a maximum sentence of up to 20 years in prison. Needless to say, Mr. Kapoor is in for a fight.

But many are still wondering if these executives will truly be held accountable? And truthfully, is it even enough at this point? Even if proven to be indirectly contributing to the opioid epidemic, how could anyone ever know how many lives were damaged or lost because the powerful played around with lethal prescription drugs to line their pockets?

For more important information on the dangers of prescription drugs, download our FREE E-BOOK “Big Secrets of Big Pharma: Why They Secretly Hope You Get Hooked”

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With recent reports showing that approximately 64,000 Americans died last year from drug overdose, and an estimated 20,100 overdose deaths linked to synthetic opioids like fentanyl, how many of those lives were impacted by drugs like Subsys being forced onto the market with bribes?

More needs to be done to stop Big Pharma companies like Insys Therapeutics Inc from exploiting the system and putting the lives of millions of Americans at risk. And not just the middle-men should be accountable, but also those sitting comfortably at the top these industries. At least this is a start. But for the individual, it all starts with taking action. Getting safe and effective treatment can not just save a life, but help someone build a foundation for a better one. If you or someone you love is struggling, please call toll-free now. We want to help. 

 CALL NOW 1-888-922-5398

Dear Media, Thank You for Bad Press: Love, South Florida

Dear Media, Thank You for Bad Press: Love, South Florida

In the past few weeks, there has been an influx of negative coverage from some very prominent voices in media, including the New York Times and most recently Megyn Kelly in an NBC News Investigation piece, about the issues that have been plaguing the South Florida recovery community. Bad news travels fast, and these days every bit of it goes viral. There is a lot to say about the topic. A lot has already been said, but this conversation means something very significant to a lot of people.

This is nothing new; stories from various sources have been published over the last few years. From local news outlets like the Sun Sentinel or Palm Beach Post, to more nationally (or internationally) known outlets like BuzzFeed, cautionary tales have been reaching out to warn people about the dangers of illegitimate and unregulated drug treatment and sober homes.

Reports have highlighted the devastation of the opioid overdose crisis, and rightfully so.

They have exposed some of the most apprehensible and illicit activities of patient brokers and fraudulent facilities.

The media has engaged in a full-on assault against the corruption and criminality of the South Florida drug treatment industry, and we have a few words for them…

THANK YOU… FINALLY!

With Gratitude

With great gratitude, we thank the media for all the coverage of everything wrong with the treatment industry, because it is about time we all addressed these problems.

Finally, we have more people paying attention to the serious and life-threatening faults of shady and illegitimate drug rehab and sober home companies. Any number of the recent reports will show that for years unscrupulous con-artists have profited millions of dollars off of the suffering of some of the most vulnerable people in the country, under the pretense of providing some semblance of health care and therapeutic value.

For too long there have been grossly unethical practices involved in those abusing the treatment industry. Human trafficking in the form of patient brokering and providing drugs to relapsed addicts in order to defraud insurers are only part of this complex issue.

Thankfully, there are finally more proactive steps being taken to prevent these issues from continuing or escalating to even more extremes. The state attorney, along with the efforts of law enforcement and task forces, are taking more action against those who exploit the system. As far as the limits and loop holes, new legislation is being advanced. Arrests and raids are putting an end to many of these illegal enterprises.

“But there is hope”, as Cynthia McFadden on the NBC news video put it. As per the interview on Megyn Kelly’s program, Palm Beach County State Attorney Dave Aronberg states that they have made 29 arrests in Palm Beach County since last July, being patient brokers, treatment center owners, and corrupt doctors and with many more to come.

Thank you… but we need more action!

With Humility

Respectfully, and with humility, we think we would all fare better without making statements that paint the entire treatment industry and the recovery community with a broad stroke of prejudice. Especially when it comes to distinguishing addiction treatment facilities from sober living facilities, because they are not the same thing. A lot of stories forget to mention that the issues with sober living may often have nothing to do with the treatment industry, and that almost no one ever send their loved ones to South Florida for sober living homes.To learn more about the difference between these two, subscribe to our blog and check out our FREE e-book: 

5 Critical Mistakes To Avoid When Picking A Sober Home

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Still, we should lay out all the facts.

Some reports will claim Florida has the worst overdose death rates in the nation. The only problem… it’s not even close to true.

For example: Florida actually had less overdose deaths per 100,000 people than 23 other states! These numbers include the top 5:

  • West Virginia- 41.5 per 100,000 people
  • New Hampshire- 34.3 per 100,000 people
  • Kentucky- 29.9 per 100,000 people
  • Ohio- 29.9 per 100,000 people
  • Rhode Island- 28.2 per 100,000 people

Meanwhile, Florida is 24th on that list. Florida has experienced increasing rates of drug overdoses over the last few years, although still not in the top 3 states as of the most recent figures. Yet, people forget to note that overdose rates don’t necessarily mean overdose deaths. The distinction may seem small, but ask any addict and they will tell you there is a big difference.

Of course we should not ignore the bad, and we all know the opioid epidemic is bad and Florida has suffered greatly. But it is an equal injustice to ignore the facts plaguing the rest of the country. It is also unjust to condemn the treatment providers who still believe in doing the right thing. It is true that there are more unethical and illegal facilities than previous years. But to assume every facility qualifies for this kind of categorization is unfair, to say the least.

Let us not forget, South Florida is home to some of the best high-quality holistic drug and alcohol treatment in the country. There are numerous addiction treatment providers who have been serving South Florida and the recovery community for decades; helping countless people in pain while making consistent contributions to the sustained improvement of their clients and their communities.

But again, we thank those who are out there challenging the current system and demanding better care. This call to action means those of us willing to suit up and show up have all the more reason to keep doing what we believe in. It means anyone looking for treatment will know what to look for and what questions they need to ask, because this is vital to keeping their loved ones safe. Asking the right questions can lead you to the right kind of help.

All this means the South Florida treatment providers who are committed to helping people will step up and show that what we do makes a difference.

For a more detailed look into the difference between addiction treatment programs and sober living facilities, download our FREE e-book:

5 Critical Mistakes When Picking a Treatment Center and How to Avoid Them

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With Hope

The impacts of the indecent and deceitful practices that have touched the treatment industry are heartbreaking. We all see the dire tragedy of it, including those of us in the treatment industry who still believe in helping people who suffer.

Accredited and legitimate treatment providers are also impacted by these problems. Patient brokers will sometimes infiltrate high quality and honest facilities disguised as patients themselves in order to recruit patients to other illegally operated facilities. Brokers sell their victims false hope, with promises like:

  • Material gifts
  • Cash payments
  • Free rent

Brokers can end up pulling patients out of treatment, against medical advice, in order to exploit their insurance benefits without equipping the individual with any level of care or even basic security. This terrible strategy is one of the obstacles that authentic treatment providers must frequently try to overcome; the outside influence of people trying to take advantage of the entire industry.

So again, THANK YOU. The more light we shine on the shady parts of what has happened, the more people will see where the greater danger exists. Addiction treatment in South Florida is NOT the problem; people who exploit addicts fighting a life and death battle and call it treatmentTHAT is the problem. Not to mention the environment in the nation that is breeding this opioid crisis in the first place.

Our hope is, as we strive with all we can to improve how we care for and address substance use disorder and its related issues, that we can inspire others to see that real recovery is possible.  We hope our dedication to creating lasting change in the lives of all the people who come to us for help will prove that people can recover, and that treatment does work.

With Compassion

Perhaps most importantly, we thank the media for raising awareness and igniting a conversation. Since the first few reports started to gain popularity, more people are talking about it. The momentum has created a greater platform, and we need to make it count. More people are connecting to the discussion, which means there is more hope than ever of finding a solution.

I will say what I said in an article last week, in case anyone missed it… we are in this together.

This unites all of us in a common objective- to end the extortion of the men and women, sons and daughters, fathers and mothers who need our compassion, now more than ever. With compassion, we can meet in the middle and have a real conversation. It means dropping the stigma of substance use disorder and having an open dialog about how we can all help each other make this country, not just South Florida but all of America, a better place for the addict who still needs help.

We still believe in the value of quality care. We still believe in the recovery community of South Florida, and because of it we are grateful that something is being done. While we still think there is plenty more to do, we are hopeful. If no one talks about it, no one will be willing to help fix it. Hopefully we will be able to move this conversation toward how we can best take care of each other, especially those who have already lost so much. Our mission is to take this topic from what is wrong with those who hurt people and turn it to what is right and what has been accomplished for the people who needed it most.

It is time we really work together to make a difference. Politicians, law enforcement, health care advocates, trustworthy and accredited treatment providers and members of the recovery community have to pull together and speak out about this if we ever want it to get better.

While some people may disagree with this piece and the delivery, the media has at least accomplished something- they have reminded us of an important part of the conversation. Surely, South Florida has an amazing recovery community, but if we pretend it is perfect it will never get better. Awareness might help us change everyone’s perspective.

So to the New York Times, Megyn Kelly, NBC News and all other news outlets, with gratitude and humility, hope and compassion… we thank you.

P.S. For more on this subject, like us on Facebook or subscribe to our blog. We look forward to keeping up the conversation.

For more information on how to find a safe, ethical and effective addiction treatment program make sure to explore more of our Palm Healthcare Company website. If you or someone you love is struggling, please call toll-free now. We want to help.

 CALL NOW 1-888-922-5398

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