A patient broker is a middleman who lures and trades a patient to a particular medical institution or a treatment center in exchange for perquisites and money. Patient brokering is defined as a practice which involves getting kickbacks in lieu of helping to enroll people who are suffering with terminal illness, chronic illness or addiction. Patient brokers are middlemen who locate patients and refer them or sell them along with their insurance coverage to medical institutions and rehabilitation centers that are willing to pay those commissions or kickbacks. Such brokers are also referred to as `body brokers’, `junkie hunters’ or `interventionists’. The practice of patient brokering has warped the health care system, blurring the fine lines between genuine medical care and profiteering.

Brokering of this nature may actually happen in several different ways. In few cases, patient brokers may approach a sober home or a treatment program center with prospective patients and solicit kickbacks or fees when they exchange information concerning such patients. In some other cases, the treatment program center or the sober home management may recruit patient brokers and retain them on their payroll.

In many cases, the patient brokers are often patients themselves who have successfully completed their treatment in a particular rehabilitation center and they are approached by the management of a rehab unit to procure patients for the clinic in return for fees or kickbacks.

Is patient brokering legal?

When a patient broker recommends any person requiring medical attention or addiction treatment to a medical institution of a rehabilitation center, he or she is indulging in an illegal act and such acts are regarded as a variant of human trafficking. The practice of patient brokering has turned rampant through acts of fraud as people are desperately trying to make some fast cash on the side and receive kickbacks by enrolling people to their affiliated rehab centers. Patients whom they refer are generally those who are suffering with disorder of substance abuse and those who are heavily insured. Such an act of patient brokering has become a widespread problem in our society. People who seek help are being used as mere pawns and these patient brokers and people who are soliciting them are profiting from exploiting such people.

Patients who are suffering with addiction disorders and who seek treatment desperately are being taken advantage of, unknowingly, for quick profit by these patient brokers. Patient brokering has become a symptom of greed that is being fed by insurance frauds. Illicit sober homes or rehabilitation centers are paying the patient brokers on account of exploiting and billing exorbitantly out of the insurance policies of the referred patients for their treatment. In most cases, the treatment is not being given entirely so that the length of receiving such treatment gets prolonged. These people would be billed for treatment that they never actually received in full and they will be billed for blood or urine tests that they never took and for many other unrelated tests and their charge.

How is patient brokering hurting the addiction industry?

Patient brokers, with their criminal intentions and acts, will continue to commit several medical insurance frauds. As a result, insurance companies are beginning to pull away from offering coverage for legitimate treatment to help genuine addicts and people recovering from alcohol addiction. If people have private insurance, it is now costing them money because their premiums are continuously going up in order to recover the costs of such thievery. The addicts who attend programs in rehabilitation centers are not being given a fair and rue chance at recovery. Only a few recover while others are given more drugs. In some cases, people have died from over-dosage. So, the act of patient brokering has not helped the addiction industry. It has damaged it further. Patient brokering can best be described as a criminal act with ulterior motives on the part of the broker as well as his or her solicitor.

Junkie hunters are always on the prowl for addicts in discos, bars and night clubs. Each addict with a handsome insurance policy they nab for a rehab center can net them a minimum of five hundred dollars. They also attract recovering addicts by offering them transportation, free housing, gift cards, cell phones, a PS4 or an Xbox or even a gym membership. For some addicts, the bait involves promising them continuation of using drugs.

What are the federal laws against fee splitting?

Medical institutions and health care professionals are fully aware of patient brokering and of `fee splitting’. There are no federal laws against patient brokers as definitions of their actions are confusing and elusive. In some places, medical laws prohibit health care professionals that are licensed to engage in offering kickbacks, rebates, commissions, bonuses or fee splitting in exchange for referrals of patients. It is certainly a violation of criminal statutes for health care providers to offer kickbacks indirectly or directly and covertly or overtly and in cash or kind for soliciting and referring patients.

Are the rehab operators and clinic management personnel turning a blind eye to patient brokering?

Most of the medical care centers’ management personnel and rehab operators are aware of the practice or patient brokering that prevails nowadays. For example, your father may be going through symptoms of a heart attack and you call an ambulance. The ambulance driver could very well be a patient broker who will take your father to a medical center that pays him a handsome kickback for referral instead of taking him to the nearest health care center or a cardiac center which offers good treatment. The managers of many rehabilitation centers are fully aware that it is a wrong practice to offer kickbacks to patient brokers in exchange for heavily insured patients but they turn a blind eye, allowing such practice to become ubiquitous because they will end up not getting lucrative business if they stuck to high moral grounds.

These types of rehab operators are forging a legal gray zone putting patient brokers on their retainer for a fixed sum every month, regardless of the number patients that are being referred by them. The selling of patients and addicts to highest bidders is on the rise. The recovery industry is thriving today and is a one-billion dollar sector and patient brokering has become their little dirty secret. Patient brokers are earning up to several thousands of dollars every year by attracting vulnerable addicts for rehabilitation centers that provide limited medical care and services and that are run by greedy operators with no expertise or training in the field of drug or alcohol abuse treatment.

Family Center for Recovery does not practice, nor does it endorse patient brokering tactics for acquisition of patients. Patients are people, not dollar signs.