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The nation's epidemic of opioid abuse has created new opportunities for insurance fraud. Health care insurance pays for the costs of recovery. That's led to a boom in residential treatment programs for addicts, some of which use deceptive marketing, fraudulent claims and what's known as patient brokering. In South Florida, that's led to a runaway growth of residential programs for recovering addicts called sober homes. From Delray Beach, NPR's Greg Allen reports.
GREG ALLEN, BYLINE: Delray Beach is a small Florida community with a charming downtown, palm trees and waves. It attracts locals, vacationers and increasingly addicts, who come here to try to get off opioids. In some parts of town, there's a sober home on nearly every block and sometimes two or three. On this block, where Michelle Siegel was walking a dog, there are at least six sober homes.
MICHELLE SIEGEL: You can usually tell. A lot of times, they have the white vans in front. And they have the do-not-trespassing signs. But I have walked down the street sometimes and seen kids just passed out, face down on the - and you ask them if they're OK. And they're like, yeah, yeah, I was just tired. I was sleeping. And you don't know whether you should get them help, whether you leave them alone.
ALLEN: As group homes for people recovering from addictions, sober homes are protected by the Americans With Disabilities Act, also, the Fair Housing Act. Those federal laws have made it difficult for local communities to limit or otherwise regulate sober homes. The state attorney for Palm Beach County, Dave Aronberg, says while there are many legitimate sober homes, there are also many others operated by unscrupulous providers. Aronberg says they tap into insurance money, offering free rent and getting kickbacks from outpatient drug treatment centers, a scheme known as patient brokering.
DAVE ARONBERG: The outpatient treatment center van picks your residents up three times a week to go drug test them, which is then billed to insurance at very high rates.
ALLEN: Treatment centers bill insurance companies not just for drug tests but also for other services like group counseling, even acupuncture. And they share the money with people supplying the patients.
ARONBERG: In return, you, as a sober homeowner, can get a nice check for the patient brokering - is what you've done.
ALLEN: Although they're there for recovery, residents of sober homes often find heroin and other drugs available.
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ALLEN: Delray Beach EMS Captain Matt Pearce says crews responded to more than 1,300 overdose calls last year, many at sober homes.
MATT PEARCE: We respond there sometimes repeatedly in the same shift. Just last night, they responded to the same sober home two times within 10 minutes, both for overdoses.
ALLEN: With a cost of $2,500 for each EMS call, it's put a strain on the city's budget. Much worse is the human toll. Countywide, nearly 600 people died of overdoses last year. It's a problem for Delray Beach and for addicts, who Aronberg says are often lured by marketers to South Florida on false pretenses.
ARONBERG: They make the individual on the other line think that they're a doctor and they're diagnosing them, when in reality, they're only reading from a script given to them by the treatment center that's paying them.
ALLEN: Rather than a recovery model, Aronberg says unscrupulous sober homes and treatment centers operate on a relapse cycle, which brings clients back time and again for treatment covered by health insurance.
NEILL TIMMONS: You know, I'm in recovery myself, six years next month.
ALLEN: Neill Timmons runs four sober homes in another Palm Beach County community, Boynton Beach. Like other reputable operators, he doesn't receive payments through arrangements with drug treatment centers. He says for someone going through recovery, landing in a good sober home can make all the difference.
TIMMONS: They're not certain, you know, if they want to stay sober the rest of their lives or return back to use. And they're, you know, just struggling with what they need to do in order - if they do want to stay sober, so, I mean, a good sober support to really guide and give them some guidance towards recovery.
ALLEN: Timmons and others who run good sober homes want more regulation. Florida's governor recently signed a law increasing the penalties for patient brokering and deceptive marketing. A study commissioned by Delray Beach found at least 250 sober homes in a town of just 60,000, about a quarter of them operating under the city's radar. Mayor Cary Glickstein is no fan of the drug recovery industry, sober homes and the problems, he says, they brought to his city.
CARY GLICKSTEIN: Patient brokering, drug trafficking, human trafficking, prostitution - it's a Pandora's box of problems that the unscrupulous operators bring to a community.
ALLEN: Delray Beach has just adopted a new ordinance that requires sober homes to be certified by an independent trade association. After adopting a similar ordinance, officials in Prescott, Ariz., say the number of sober homes in their community is now a third of what it once was. Greg Allen, NPR News, Delray Beach, Fla.
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