Medi-Cal pays for low-income patients to receive care at drug rehab facilities.
But this dependable source of health coverage can be taken advantage of. Clinical treatment programs can cycle patients through their facilities, and when funding runs out, move them to another facility where more Medi-Cal support can be earned.
When this practice ends up causing harm or the death of a patient, families can seek justice and support.
Cycling Patients for Drug Rehab Profit
The strategy of cycling patients through drug treatment programs to earn insurance money is an unethical strategy that’s been in use for years.
Patient Cycling: The repeated process of treating Substance Use Disorder (SUD) patients for as long as their insurance coverage lasts. Then patients are discharged, and many end up relapsing and returning, allowing facilities to draw from Medi-Cal support all over again. It may also involve shuffling patients to an affiliated outpatient program, where Medi-Cal will cover additional, lower-level care. It’s a cycle that can be repeated.
In some cases, facilities have been accused of actually providing drugs for an overdose intentionally, simply to keep a patient in the cycle.
The companies at the heart of these schemes end up creating so-called “treatment mills.” An entire segment of the rehab industry becomes all about cycling patients back and forth to maximize profits.
Where Does the Money Come From?
If the patient-cycling involves low-income Substance Use Disorder sufferers, the profit usually comes from the state’s Medi-Cal program that pays for treatment.
Medi-Cal is California’s application of the federal Medicaid program. It allows low-income people to secure often no-cost healthcare benefits paid for with state and federal funding.
The Dangers of Treatment Mills
These companies usually offer low-quality care, often providing little one-on-one treatment time with doctors and even less counseling with a professional.
The patient’s recovery isn’t the focus. Keeping them rotating through care and drawing insurance support is the goal.
Patients may also end up being discharged before they are ready, simply because insurance money has expired.
See: Drug Rehab Patient Dumping and Abandonment
Patient Recruitment in California Rehab Networks
Another practice that often feeds into Treatment Mills and cycling is known as “patient brokering” or “patient recruitment.”
Some unethical drug rehab providers can recruit patients simply to boost the insurance money they represent.
Facilities may also pay agents or those working at other drug treatment programs. As patients are discharged, the agents guide them to a specific drug clinic. The agents receive kickbacks for their recommendations and for each patient that is admitted.
This is an illegal practice according to state and federal law. The act can also serve as evidence of negligence when a family must sue a drug treatment center after a loved one is allowed to die.
Evidence of a Treatment Mill
After a loved one’s death in a treatment program, families can seek help with funeral costs and in replacing the income the victim may have supported them with.
But to do this, families will need strong evidence of negligent and fraudulent treatment mill behavior.
A California Wrongful Death Drug Rehab Facility Lawyer can help families collect the evidence they need to show that a facility and its staff were negligent. There may be obvious mistakes that led to a patient being able to overdose on a drug like Fentanyl. There may be details that illuminate how a loved one was left without help while dealing with life-threatening withdrawal side effects.
These are just a few of the types of actions that leave a rehab center liable for a tragic death:
- Evidence that patients in distress went undiscovered for too long due to a failure in regular bed checks.
- Evidence that understaffing left patients without proper monitoring.
- Evidence that patients had easy access to drugs in a supposedly “zero-tolerance” environment, either intentionally or unintentionally.
- Evidence that a recruiter was paid to guide a patient or family members to consider a certain facility.
- Evidence that a patient was discharged before they were ready for financial reasons.
These and other indicators can illuminate the steering of patients into a harmful cycle. Sometimes it’s as easy as following the money a facility earned with each relapse.
Contact Us if a California Rehab Facility Caused Your Loved One Harm.
Attorney Martin Gasparian offers a free, confidential consultation to all families who lost a loved one at a negligent California rehab facility. You may feel you’re the only one speaking up for a lost loved one. But now you don’t have to stand alone.
Call us today to set up a free case review. There’s no obligation, but if you need to hire us, we don’t charge your family anything upfront. We are only paid if we win the case for you. Then our fee comes out of the settlement check that a negligent facility must write for your family.