How the opioids bill seeks to address patient brokering

The comprehensive opioids bill passed by the Senate and Congress includes a provision to protect opioid use disorder patients from a predatory practice known as patient brokering, according to The Washington Post.

Here are five things to know:

1. Patient brokers are usually third-party entities that recruit patients to addiction treatment centers in return for financial kickbacks from the facilities.

2. Sometimes the patient brokers help uninsured patients enroll in private insurance coverage, paying their premiums until the patients exhaust their benefits. The Washington Post also cited several reports of brokers making drugs readily available to patients so they relapse and search for another provider.

3. Once these patients are in the treatment centers, the facilities make efforts to bill the plans at higher out-of-network rates and submit fraudulent claims to insurers for services.

4. If the opioid bill is signed, it would be a federal offense to provide or receive these types of payments for patients with private coverage. The kickback payments are already illegal under Medicare and Medicaid.

5. Anyone found guilty of these arrangements could face up to 10 years in prison or as much as $200,000 in fines.

More articles on opioids: 

Limited access to addiction treatment pushes patients to Suboxone black market

3 ways to help opioid use disorder patients access specialized treatment

Scripps ER physician Dr. Roneet Lev: How hospitals are 'missing the boat' when it comes to the opioid epidemic

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Learning Opportunities

Featured Whitepapers

Featured Webinars