Patient Brokering and Drug Treatment

What is "patient brokering" in drug treatment?

asked 18 Apr '16, 19:53

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CleanAndSober
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The concept of "patient brokering" exists not only in drug treatment, but in all substance abuse treatment (drugs, alcohol) as well as addiction treatment in general (sex addiction, eating disorders) and healthcare overall. Patient brokering is controversial in addiction treatment because many substance abuse treatment programs are not regulated as healthcare, so there is less natural enforcement coming from professional licensing requirements.

(18 Apr '16, 20:00) admin ♦♦

drug-treatment

Drug Treatment

Patient brokering is more common in drug treatment than other medical treatment areas due to lower licensing restrictions for addiction treatment in some states.

drug-rehab

Drug Rehab

Patient brokering is more common for drug rehab than drug detox.

alcohol-treatment

Alcohol Treatment

Patient brokering is more common for alcohol rehab than alcohol detox.

alcohol-rehab

Alcohol Rehab

Alcohol rehab is sometimes unregulated, outside of medical oversight. In some cases candidates for alcohol rehab are not considered medical patients, and thus not protected against patient brokering.


I think you mean selling patients, sometimes called "brokering" by those who do it to try and make it sound more professional.

Patient selling (brokering) is illegal in all states, because patients are protected by law. However some operators will claim that someone seeking help with an addiction is not a patient. Sometimes they will say they are only providing information, or only "connecting" people to providers.

In all states medical people are not allowed to pay people to bring them patients, although again, some unscrupulous people will call it "marketing" and try and pass it off as that.

In some states (like Florida) there are laws that specifically make it illegal to pay for patients. For example, Florida law states

It is unlawful for any person, including any health care provider or health care facility, to: (a)?Offer or pay any commission, bonus, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, to induce the referral of patients or patronage to or from a health care provider or health care facility see http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0800-0899/0817/Sections/0817.505.html

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http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0800-0899/0817/Sections/0817.505.html

(18 Apr '16, 20:12) TreatmentPro

Florida has the largest number of substance abuse treatment centers in the United States, and many laws on the books intended to protect patients from patient brokering:

Florida Anti-Kickback Statute – § 456.054 defines a kickback as a paytment that is "not tax deductible as an ordinary and necessary expense"

Florida Patient Brokering Act – § 817.505 see above, makes it illegal to offer treatment providers access to people who have asked for help and are waiting to be connected to help (this makes most "call centers" and "lead brokers" illegal in Florida)

Rebates Prohibited – Hospital, ASC, Mobile Surgical Facility – § 395.0185 Similar to the Patient Brokering Act, but specifically assigned to hospital, ambulatory surgical center or mobile surgical facilities. There are similar laws for pharmacies (Rebates Prohibited – Pharmacy – § 465.185), nursing homes (Bribes, Kickbacks, Certain Solicitations Prohibited – Nursing Homes – § 400.17) and several other categories. There are also more generic laws prohibiting medical kickbacks, medicaid kickbacks, etc.

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Under that Florida law, patient brokering is a "Felony 3rd Degree" so quite serious.

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Also the law has exemptions, which are the loopholes some businesses use to rationalize selling leads for addiction treatment

discount, payment, waiver of payment, or payment practice not prohibited by 42 U.S.C. s. 1320a-7b(b) Any payment, compensation, or financial arrangement within a group practice as defined in s. 456.053, provided such payment, compensation, or arrangement is not to or from persons who are not members of the group practice. Payments to a health care provider or health care facility for professional consultation services Payments by a health care provider or health care facility to a health, mental health, or substance abuse information service that provides information upon request and without charge to consumers about providers of health care goods or services to enable consumers to select appropriate providers or facilities, provided that such information service: 1.?Does not attempt through its standard questions for solicitation of consumer criteria or through any other means to steer or lead a consumer to select or consider selection of a particular health care provider or health care facility; 2.?Does not provide or represent itself as providing diagnostic or counseling services or assessments of illness or injury and does not make any promises of cure or guarantees of treatment; 3.?Does not provide or arrange for transportation of a consumer to or from the location of a health care provider or health care facility; and 4.?Charges and collects fees from a health care provider or health care facility participating in its services that are set in advance, are consistent with the fair market value for those information services, and are not based on the potential value of a patient or patients to a health care provider or health care facility or of the goods or services provided by the health care provider or health care facility.

That last one is the important one for most lead sellers -- if they qualify the lead in any way, and offer the lead for sale using a pricing system that is based on that information (suggeting the patient is worth more than other patients), they are probably breaking the law.

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Asked: 18 Apr '16, 19:53

Seen: 3,652 times

Last updated: 18 Apr '16, 20:29