Tag Archives: treatment providers

Top 10 Reasons to Register for the FARR Annual Conference

1. If Recovery Residences don’t demonstrate that we have successfully organized under the FARR umbrella, well-funded and highly organized NIMBY forces will kick our butts in the next legislative session.

2. We’re now beginning to set the agenda rather than simply react to those fueled by stigma and ignorance. This requires unity, solidarity and scale. Join us and help make a difference!

3. Responsible and ethical service providers within the recovery residence and IOP sectors must group together now so that all stakeholders can distinguish the “good guys” from the “bad guys”.

4. This is your trade association! Your voice and active participation matters. Sitting idly by, pointing fingers and lamenting the sad state of affairs isn’t going to change much, is it? Let’s get connected!

5. Those of us who are “fighting the good fight” on behalf of this sector need your support. Surely it’s not too much to ask for a one day & $95.00 commitment to support those who volunteer hundreds of their own?

6. Conference content is timely, on task and addresses important issues impacting all sectors along the care continuum. Together we can shape the future of ROSC here in Florida.

7. State legislators and local, municipal leaders are betting on their belief that as a group we’re too self-centered to gain organized momentum. Don’t let them gloat next session with a smug “told you so”.

8. FADAA represents the ‘managed entities” here in Florida. These are potential referral sources for many recovery residences. DAF, CARP, BARC, Henderson, New Horizons, Operation Par, Stewart Marchman to name but a few.

9. Aren’t most of us all about the value of peer-to-peer interactivity? This conference is a very real opportunity to network with your peers and engage in dialog concerning issues that directly impact the entire spectrum.

10. In the substance abuse treatment continuum, it all comes down to “reputation, reputation, reputation”. Florida has developed a national reputation as the Wild, Wild, West. Together, we become a force to restore our good name.

If you are interested in attending, you can register here. Get a conference schedule here and I hope to see you at my townhall discussion about the “Legal Challenges with Rent Assistance.”

The Future of Substance Abuse Treatment

I just received the attached from Addiction Professional Magazine, which, in my opinion, is a must read about the antiquated system of substance abuse treatment models that are employed and how existing RESEARCH needs to be reviewed and implemented.

Quote: [Integration] is not a gift to the mental health and substance abuse field. We¹re not being given something just because it’s fair, just because it’s our time, or just because there¹s a Democratic administration. You can¹t run the rest of healthcare if you don¹t manage substance use and mental health.

Me: Housing is an integral part of this equation as well. The best treatment outcomes occur when safe and secure housing exists. It’s a human necessity.

This is a great article that discusses Integration:
Integration demands highest standard of care

Wellington town hall meeting to address ‘sober homes’

Anyone with an interest should absolutely attend this meeting. Don’t let it be a one-decided discussion. Let them see the “Faces of Recovery” as well as hear from you that you and those you compassionately serve will not tolerate being treated as a second-class citizen due to your/their disability. I am reminded the following poem “First they came” is a famous statement and provocative poem attributed to pastor Martin Niemöller about the cowardice of German intellectuals following the Nazis’ rise to power and the subsequent purging of their chosen targets, group after group.

First they came for the Socialists, and I did not speak out– Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out– Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out– Because I was not a Jew.

Then they came for me–and there was no one left to speak for me.

Get details here!

OIG’s 2014 plan promises scrutiny for behavioral health

By Dennis Grantham, Editor-in-Chief of Behavioral Healthcare

In a recent story, “Compliance programs stress effectiveness” (Behavioral Healthcare, Nov./Dec. 2013 issue), Fabio van der Merwe, director of quality improvement and compliance at DeKalb Community Services Board (Atlanta, Ga.) noted that each year, the Office of the Inspector General (OIG) for the Department of Health and Human Services releases an annual work plan.
This plan, he says, “puts compliance officers ‘on notice’ as to the focus of federal Medicare and Medicaid enforcement activity for the coming year.” In its recently unveiled 2014 work plan, the OIG committed to continuing a range of investigative activities involving behavioral health.

Read the full article here.

Letter from DCF RE: Patient Brokering

Many of you have called me regarding letters you may have received from DCF regarding Patient Brokering. Please be aware that the letter has been sent to all providers and not to anyone specifically accused of any wrongdoing.

That said, you should remain vigilant that you are closely monitoring any activity by your staff that could be construed to violate s. 817.505, Fla. Stat., the Patient Brokering Act. I have attached a copy for your records.

For purposes of the Act, the repeat question I receive is regarding how to effectively and legally use marketing companies to obtain referrals for new patients. The provision in the statute which addresses that point can be found within subsection (i) which allows for:

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.

Should you have any questions or concerns about your compliance with this provision, please don’t hesitate to give us a call.

Insurance Fraud – More Fraud in the Substance Abuse Drug Screening Urinalysis Industry

Meant to include this one earlier, brought to our attention from our friends over at PathologyBlawg.com

A chain of opiate addiction recovery centers, headquartered in Harrodsburg, Ky., and a Russell Springs, Ky., clinical laboratory, along with two physician owners, agreed to pay the U.S. Government millions of dollars to resolve civil allegations that they fraudulently billed federal health care programs for medically unnecessary and excessive urine tests.

Strangely, DOJ and the states Attorney Generals don¹t see to be concerned about the same abuse in the private insurance sector.

However, something to chew on – are medical plans obtained through the Federal Healthcare Exchange (or a state exchange) elevated to a federal health care program. I assume the answer is “no” as a mere result of legal definition, but we will wait and see.

Still, the fox appears to be the only one watching the hen house.

Check out these articles:
Kentucky Addiction Treatment Center, Clinical Laboratory and Two Physician Owners to Pay $15.75 Million to Resolve Allegations of Fraudulent Urine Drug Testing

Attorney states cash kickbacks from urine drug screen lab are perfectly legal

Blue Cross Accuses Drug Test Co. Of $36M Fraud Scheme

Further Discussions on the Marketplace Impact of the Affordable Care Act

As initially predicted, the marketplace is moving towards consolidation of services and this may likely begin to see capture in the substance abuse treatment services in the coming 12-36 months. Possibly later.

The trends leading to this uptick in deals over the past year or so increasing health care costs, growing demand for services, consolidation of doctor groups were in place before the law. But experts say the ACA magnified their importance and expedited hospitals’ response.In one sense it just means there’s a higher need for medical office buildings. At the same time, hospitals are trying as they acquire physician groups to gain market share and use the physicians as a gateway into the market, said Ross Yustein, chair of Kleinberg Kaplan Wolff & Cohen PC’s real estate group, which has an unusual expertise in medical office building development deals.

Read this article about Hospitals Turn To Off-Campus Offices Under ACA

CMS publishes final rule on direct patient access to test results

By The Pathology Blawg
The Centers for Medicare and Medicaid Services (CMS) yesterday published its final amendments to HIPAA and CLIA that will allow patients to have direct access to test results.

I talked about this back in October 2013 when HHS announced the patient access to test results final rule would be released soon.

In the broadest terms, the new rules change CLIA’s definition of “authorized person”. Until this rule, an “authorized person” was “the individual authorized under state law to order or receive test results, or both.” In many states, that meant only the physician, or other test-ordering health care provider, and not the patient.

Read the full article here


As part of my ongoing commitment to keep Palm Beach County safe Sen. Jeff Clemens and I are gaining even more support on our bill regarding sober homes. According to Delray Beach city rental housing inspector Marc Woods, only half of Delray Beach’s 550 sober homes have complied with a law the city has imposed to verify the number of tenants living in rental homes. Additionally, people coming to the city for recovery are estimated to have committed over half of the property crimes seen in Delray Beach in the past year. Delray Beach is not the only city with this concern; all of Palm Beach County could be at risk – unless we act now.²

These ³facts² remains anecdotal, speculative, and stereotypical at best, and discriminatory and unfairly stigmatizing at worst.

Let me be clear, I strongly support legitimate and targeted regulations to ensure that persons in recovery are protected from predatory landlords and unscrupulous treatment providers.

But throwing cavalier statements around about people in recovery causing 50% of the crime in Delray Beach is absolutely absurd, reckless, and quite frankly, continues to paint the City of Delray Beach (and now, this specific legislation) in the light of a government hell-bent on getting rid of ³those people² at all costs.

Marc Woods should be ashamed of himself.

See the press release below:

January 8, 2014 Chauncey Graham (561) 540‐1140

TALLAHASSEE, FL ‐‐‐ Florida State Senator Jeff Clemens (D‐Lake Worth) and Representative Bill Hager (R‐Delray Beach) hope to put the brakes on the unchecked proliferation of “sober homes” that are changing the character of neighborhoods around the state.

Many communities have been virtually overrun by the number of so‐called “sober homes” that have emerged in the middle of neighborhoods. These unregulated facilities can potentially house twenty to thirty individuals renting space from a landlord with an eye more to maximizing profits than providing actual treatment, and they can also attract criminal elements such as drug dealers hoping to sell to residents.

While some city officials claim that thousands of these homes have opened across the state, the data is unreliable because the state has no means of tracking sober homes. SB 582 and HB 479 will allow the state to track sober house transitional living homes by providing rules for the registration and operation of these type of substance abuse service facilities.

“While many businesses are restricted from operating within single‐family neighborhoods, sober homes can open virtually anywhere,” Clemens said. “Some of these so‐called homes are destroying neighborhoods and providing little benefit to residents or the community. We need to get a handle on the problem.”

“Dating back to my service on the Boca Raton City Council, I have been keenly aware of the neighborhood challenges relating to so‐called sober homes. It is time to take legislative action,” Hager said. “Our proposal regulates sober homes in terms of licensing, screening those who operate these homes and gives the Department of Children and Family Services the ability to inspect the homes on a regular basis. Way too many problems have been reported to local officials in connection with some of the sober homes to permit them to continue to operate without regulation.”

Currently, sober homes can be established anywhere by anyone and, while claiming to provide assistance for recovering addicts, oftentimes do not offer treatment programs or services. The proposed legislation will outline where and how sober homes can be operated and address public safety issues that result from poorly run facilities.

Shifting Away from Fee for Service Towards Coordinated Care Payment Models

I know I sound like a broken record on this one, but the substance abuse treatment industry is now in the same boat as the rest of the healthcare payment model when it comes to reimbursements. That¹s good news for many (more people covered with insurance + parity in services).

However, that also means that treatment providers need to start planning ahead for the eventual migration away from the fee-for-service model and towards a coordinated care model.

While this article suggests that it is the states which need to figure it out, I still believe that the private sector is in the best position to determine cost efficiencies and then work with state legislators on crafting workable solutions.

But there is no doubting (in the absence of amendments or repeal of the Affordable Care Act) that treatment providers who rely upon private pay insurance must begin to analyze their business models for future sustainability.

Read the Modern Health article here: