Health Insurance Company Reimbursement Methods Are Killing People

Health Insurance Company Reimbursement Methods Are Killing People

It seems some health insurance companies are routinely sending payments for substance use treatment directly to patients, a practice some claim is merely an oversight, but may actually be a mechanism to discourage providers from offering out of network services. This often translates into a check for thousands of dollars being sent directly to a patient in recovery very soon after treatment, with the expectation that the patient will forward the money onto the treatment provider. The failure to deliver these checks can have obvious financial and legal consequences, but even more dangerous, it can and has cost patient lives.

The headlines are more frequent, and the issue persists. Addiction doesn’t discriminate; people who struggle with SUD come from every race/ethnic and socio-economic group. But when any person abuses drugs, their brains and thought processes become compromised. Their decision-making skills aren’t as sharp. Some seek treatment. But even after completing treatment, it often takes enormous effort to resist the urge to use.

Now imagine dangling a large sum of money in front of someone in the early stages of recovery. For many, you may as well just hand them the drugs they fought so hard to quit.

Dr. Deni Carise, Chief Scientific Officer for Recovery Centers of America, says: “Even when patients sign forms instructing their health insurance companies to send reimbursement payments for approved services directly to treatment providers to pay for treatment – known as an ‘assignment of benefits’ – this money is instead being put in the hands of the patient. This suddenly becomes a genuine temptation to return to drug use.”

Where is the accountability here? Why would health insurers continue this dangerous practice? And does this happen as often with other medical procedures?

For nearly 30 years, Deni Carise, Ph.D., has served as an important national voice on substance use disorder, treatment, and recovery and regularly speaks at national conferences on current trends in the field. She is a clinical psychologist and assistant adjunct professor at the University of Pennsylvania and currently serves as chief scientific officer for Recovery Centers of America, a locally accessible, evidence-based treatment provider. Dr. Carise has provided consult for the White House and internationally with treatment providers in other countries to develop national systems of clinical treatment delivery. She has published over 100 articles, books, and chapters on addiction and related topics. With extensive knowledge, media experience and her own personal experience in recovery, Dr. Carise speaks in plain truths and succinct sound-bites about the scope and stigma of addiction, the quest for treatment, and the challenges of recovery.