DOJ accuses addiction recovery providers of offering kickbacks to patients, running 'unsafe' facilities
A for-profit substance abuse treatment provider in Massachusetts is accused of violating state and federal fraud and kickback laws after it allegedly offered inadequate free housing to Medicare and Medicaid patients, effectively enrolling thousands seeking addiction recovery in a treatment plan that put their health at risk.
According to a complaint from the U.S. Attorney’s Office in Massachusetts, Bournewood Health Systems and First Psychiatric Planners, provider of behavioral health and substance abuse services, used the promise of free housing to entice desperate patients into its programs, limiting their options while inappropriately billing Medicare and Medicaid. The free housing incentive, according to the government, is a form of providing kickbacks.
“The Anti-Kickback Statute prohibits providers from offering or paying, directly or indirectly, any remuneration—which includes money or other things of value—to induce Medicare and Medicaid patients to select the provider’s services,” the statement from the U.S. Attorney’s office reads. “The governments do not contend that any substance use patient knowingly accepted the defendants’ kickbacks.
According to the complaint, Bournewood knowingly placed patients in sober homes as part of its “Partial Hospital Program”, growing their patient census and increasing the amount of reimbursement received from insurers, including Medicare and Medicaid. The government also alleged that some of these sober living facilities were "unsafe" and overcrowded, with Bournewood receiving warnings of sexual harassment and solicitation, medication theft, bed bugs, and overdoses. In their statement, the U.S. Attorney’s Office alleges Bournewood was aware of these problems but continued to place patients in these homes, improving their revenue.
The investigation into operations at Bournewood were prompted by allegations brought in a lawsuit filed by a whistleblower. Nothing has yet been proven in court, and Bournewood has not responded to the claim at time of writing.
In a statement released earlier this summer, Bournewood Health Systems welcomed a new CEO. In the announcement, the health system said it has been providing behavioral healthcare to patients for more than 140 years.