"Tom Horvath, Ph.D., had two small residential treatment programs in California: one had six beds and one had four. The programs, called Practical Recovery, required abstinence while patients were there (Horvath is also president of Smart Recovery, which has mutual support groups around the country in which participants are not required to be abstinent). Charges ranged from $42,000 a month to $54,000 a month. 'We had a number of clients who paid cash to do that,' he told ADAW last month. 'But we weren’t in a mansion, like in Malibu, and a lot of folks are more interested in a man- sion than in treatment.' So Practical Recovery used out-of-network insurance policies as much as possible."
"Out-of-network covers nonparticipating treatment providers, but there is usually a copay. When patients heard they would have to write a check for thousands of dollars for their copay, they told the intake coordinator they had found another facility that would not only forgive the copay, but would send them a plane ticket. 'This is insurance fraud; we don’t do that,' Horvath told us. Un- able to compete with the providers that do this, he shut down his pro- grams. He was not a member of the National Association of Addiction Treatment Providers, because 'I couldn’t join an organization that so explicitly endorsed the disease mod- el as the way to treat this problem,' he said. 'And many of their members are part of the problem anyway.' Horvath said the solution lies with the insurance companies. 'They’re the ones with the money; they set the rules,' he said. If insurance companies made sure that patients paid co- pays, there would be less fraud. 'I think that addiction is such a small piece of what insurance companies do, they don’t pay attention to this,' he said. Currently, Horvath is running an outpatient program with about 10 staffers. 'I’m investigating other options,' he told ADAW. 'In the past I was out-of-network, but I’m going to look at being in-network as well.”
~ Alcoholism & Drug Abuse Weekly, p. 7-8. DOI: 10.1002/adaw
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Facebook TwitterI would say for every ten evaluations we have roughly 6-7 will tell us that although they would prefer to attend our program due to our reputation, but that they have been told by a few other programs that they will just accept their insurance as is, which of course is not only against the law but this illegal practice has been very destructive to our industry as a whole.
On one hand as an industry we already are having to deal with these extremely POWERFUL insurance companies that would like to see as many treatment programs close as possible, and on the other, we are having to compete with some very bad players in our own industry. Of course being around for so long i speak to some of the other longer standing programs which many are struggling to stay open… just because we refuse to cave-in and engage-in some of these unethical and illegal practices. I love this industry, and what we stand for. It is what I do best in my life. yes, this is a very sad situation!
As an ATAC member, on the bright side of things, due to our hard working and amazing leadership whatever programs that manage to stay around through this difficult time I believe will be walking into 2018 in a much different light :)
Our ATAC leadership is non-stop. They currently have many different pieces of legislation working their way though the legislation process. by the way, many of these issues which ATAC is attempting to deal with using the legislation process are either to uphold current law or make law. What is great is that these pieces of legislation are to deal with both… these powerful insurance companies and also to get the players in our industry to follow the highest industry practices or they will have to get-out
I certainly hope that my programs are still around when once again respect and dignity are restored to this industry, this industry which I and many others have been able to express our God given talents with others in great need.
Mr Horvath, I wish nothing but the best for your future and what you have to offer to our industry.
Many Blessings,
Anthony Lopez,
Insight Treatment Programs :)