Patient brokers, or patient marketers, actively recruit patients and direct them to particular treatment facilities in exchange for a fee or some type of compensation. In this post, we will take a closer look at patient brokering: what it is and what our state’s law says about it.
As West Palm Beach criminal defense attorneys who defend individuals accused of patient brokering, we are often asked about the legality or illegality of this particular practice. While this used to be a very gray area of the law, in the last two years, Florida law enforcement has heavily enforced it, arresting hundreds of individuals involved in patient brokering schemes. In this post, we will take a closer look at patient brokering: what it is and what our state’s law says about it.
In short, patient brokering involves trading patients for money or other incentives. Patient brokers, or patient marketers, actively recruit patients and direct them to particular treatment facilities in exchange for a fee or some type of compensation. Most commonly it involves a transaction between substance abuse treatment facilities whereby one facility pays another a substantial sum of money to refer patients for treatment and testing. In many cases, groups will also target the suffering individuals themselves, offering to pay them to seek treatment or testing at a particular facility.
The most common patient brokering scenario looks like a network between sober homes, addiction treatment centers, and the individuals battling addiction. For instance, an addiction treatment center will approach a sober home that houses individuals recovering from substance abuse and pay them money (sometimes up to $500 per person) to send them insured patients for treatment and testing. Some sober homes supply patients for outpatient programs at recovery centers that charge insurance companies steep fees for drug testing. This can result in payouts of millions for these outpatient facilities.
In addition, some groups will reach out to struggling addicts to offer them money, free plane tickets, assistance with rent or grocery bills, or other incentives to induce them to seek testing at a particular lab or treatment center. For instance, some groups will pay individuals up to a few hundred dollars a week to seek treatment at a particular center or to present for testing at a particular lab. By doing so, these groups are essentially creating more patient brokers – those who can “market” the opportunity to make money or win incentives for embarking on a certain course of treatment.
Another common scenario occurs with labs. The urine of those battling drug addiction can be worth millions of dollars to lab operators, sober homes, and treatment centers. Often, labs will offer to pay treatment centers or sober homes substantial amounts of money to refer patients. In some cases, insurance companies will pay $5,600 for every urine test administered at a lab.
These schemes are profitable not only for the sober homes and facilities involved, but also for many of the insured individuals. However, it’s been deemed a dangerous activity as many of the patients who are referred to treatment centers may not necessarily receive the proper treatment. Many of them are passed through treatment centers quickly and receive subpar treatment, only to relapse later.
Florida law prohibits patient brokering when committed by facilities that accept Medicare and Medicaid-insured patients. Simply stated, the Florida statutes prohibit anyone – including a health care provider or facility – from paying any commission, bribe, or kickback in order to refer patients. Convictions for taking or giving bribes or kickbacks for patient referrals can carry penalties of up to five years in prison and up to $200,000 in fines per count.
In the last two years, Florida law enforcement has started to heavily enforce the prohibition against patient brokering, focusing not only on substance abuse treatment centers but also on labs. The enforcement efforts follow the Florida legislature’s recent $275,000 grant to Palm Beach County, which State Attorney Dave Aronberg and others have used to launch the County Sober Home Task Force – an effort dedicated to targeting individuals involved in brokering patients in Florida sober homes. Since late 2016, the Task Force has focused on treatment centers and labs throughout Palm Beach County, resulting in hundreds of arrests of those who either committed patient brokering or conspired to do so.
If you’ve been accused of patient brokering or conspiracy to commit patient brokering, you need to engage a skilled criminal defense attorney. Because the laws surrounding health care facilities often look like a patchwork of State regulations, this can be very complex territory and you should not try to navigate your case on your own.
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