If you’re looking to go into a rehab facility to cure your drinking or drug problem, congratulations! You’re already taking the first steps of the path to recovery! However, the first steps are the hardest for many people and their families. Many don’t realize that choosing the correct rehab center is just as important as choosing any other place to do business with. After all, doctors are really only out to help people, right?
This is true in most cases. However, there are more than a few disreputable players from disgruntled employees to hackers and even doctors who have found various ways to scam extra cash from other doctors, insurance companies, and patients alike by cheating the system. Here are six of the most common rehabilitation scams found in the rehab industry and how you can protect yourself where you can.
Table of Contents
- 1. Patient Privacy Violations
- 2. Patient Enticement
- 3. Insurance Over-Billing
- 4. Misrepresentation of Services
- 5. Listing Theft
- 6. Patient Brokering
- Did this article answer your questions?
1. Patient Privacy Violations
What Are Patient Privacy Violations?
A patient privacy violation, also called a HIPAA violation, is a serious breach of patient privacy that can result in a hefty fine for offenders. The amount of the fine varies by state and can reach as high as $50,000 per occurrence with an annual maximum of $1.5 million.
The HIPAA Act is overseen by the US Department of Health and Human Services Office of Civil Rights and thus are in charge of investigating violations. Some of the most common causes of HIPAA violations include:
Failure to secure patient records
Patient records should be kept in a secure location to which only authorized personnel have access.
Failure to encrypt patient data
Medical offices are responsible for storing patient data in such a way that it can’t be easily read by third parties. Many offices choose strong encryption to achieve this.
While it may not seem like such a big deal, medical information is a veritable treasure trove of personal information including names, addresses, social security numbers and credit card information, all of which is easily sold on the dark web, where it is purchased for identity theft purposes.
A Hospital Hack Caused A Patient To Die
If that doesn’t sound scary, it gets worse from here. As this article detailing a high-profile case in Cologne, Germany illustrates, hackers can also lock an entire hospital network with ransomware, making important records inaccessible, which has put lives at risk in the past. You need only look up information on a man named Brian Selfridge, a cyber security analyst that performs risk analysis for many hospitals across the country, to find out just how dangerous a data breach can truly become.
Loss or theft of devices containing patient information
Sometimes patient information is stored insecurely on cell phones and tablets, allowing dishonest employees or third parties to gain access to sensitive patient information, as this article about a data breach at Sunglo Health Home Services shows.Insufficient training – Medical offices should ensure that their employees are kept up to date on the latest HIPAA information. The laws change occasionally, and what may have been considered legal this year may be considered illegal next year.
While gossip around the office water cooler is commonplace, discussing a patient’s personal medical information is never acceptable and is a clear violation of the HIPAA Act.
Sometimes employees of medical practices will maliciously leak information regarding patient information. It is up to the company to ensure that these intentional releases do not happen.
How to Avoid Patient Privacy Violations
Although the HIPAA Act protects your personal medical information while it’s being held by most healthcare providers and insurance companies, there are steps that you can take to protect your personal health information as well. First, ask if your provider is covered under HIPAA; most reputable facilities will be. Your personal information is not protected if your rehab facility is not covered under the HIPAA Act, and there are a few of these dotted around the country.
Second, if you don’t want certain information to become public, do not post it online, especially over social media. As we mentioned before, hackers love to steal medical information for a variety of reasons, and most people don’t even realize that hackers are collecting this information straight from their own social media profiles and the posts they make.
2. Patient Enticement
What Is Patient Enticement?
Patient enticement is exactly what it sounds like – a treatment center will sometimes entice patients with free services, food, rent, or other special services. Offering any type of kickbacks or remuneration to new clients is illegal under federal anti-kickback laws and possibly state anti-fraud laws as well, depending on the state in which you live. This is especially true when the client is on a Government-funded insurance program (ie MediCare, VA benefits, or MedicAid.)
How to Avoid Patient Enticement Scams
If a treatment center offers you any sort of remuneration or kickback in exchange for referrals, be extremely wary. Politely refuse and report the treatment center to the proper fraud hotline for your particular Government insurance program. This will keep you out of legal hot water when the Government goes to prosecute the treatment center. Even receiving such kickbacks is illegal. You could be held responsible for repayment or lose your benefits entirely.
3. Insurance Over-Billing
Insurance over-billing is a common type of insurance fraud where treatment centers will intentionally bill insurance companies for unnecessary services in order to obtain more money. As a common example, urine tests were once conducted every couple of days at a price of more than $1,000 a pop. Insurance companies lost so much money as a result of these scams that they had to hike monthly premiums in order to recuperate their losses, leaving the patients holding the bag.
4. Misrepresentation of Services
Anyone who knowingly misinforms patients about the quality or type of services they provide, their accreditation status, and/or their affiliations with other facilities or organizations is guilty of misrepresentation of services. This type of scam fools the patient into believing they’re going to get services they have no intention of delivering.
How to Prevent Misrepresentation Scams
The best line of defense against misrepresentation scams is to do your own research. Look up reviews for the rehab center in which you are interested, and ask people around the area if they would recommend that particular rehab center. If you find or hear anything about a rehab center misrepresenting anything about their services or accreditation, stay away at all costs. This is the best way to protect yourself against this type of scam.
5. Listing Theft
Listing theft is defined as the act of hijacking Google search results or Google Maps listings by exploiting its suggested edits function. The intent behind this type of scam is to gain more exposure than they would otherwise receive from a valid listing.
6. Patient Brokering
What Is Patient Brokering?
Patient brokering is an illegal practice where doctors will pay third-party brokers to find patients for them. These brokers prey upon unsuspecting patients and their families at the most vulnerable stage of the process, leading them to believe that choosing the facilities they represent will be the best choice for the patient in the long run.
Here’s where the problem comes in: These facilities will often charge exorbitant fees while providing little to no actual help. The goal of these facilities is to keep patients addicted so that they can continue to scam money for their “services” while fooling their families into believing that it will be the best decision they’ve ever made in the long term.
How to Avoid Patient Brokers
This article from Turning Point of Tampa provides useful tips on how to avoid getting sucked into the patient brokering scam.
The first thing you should do is call up the facility, and ask them if they’re an accredited and licensed facility. Most legitimate facilities are.
Next, look up the company name in the phone book or on Google, and see if they’re listed in your state. Many patient brokerage scams send people out of state for rehab. This brings us to our last bit of advice.
Finally, it should go without saying that you should always find a local rehab center.
You have just learned six of the most common rehab scams in the market right now. However, be mindful of the fact that new scams are being created on a regular basis, so we advise you to keep checking up on the latest scams so that you can become a better-informed consumer. We realize that finding the right rehab center for you can be an overwhelming task, but trust us – it pays to do the extra research.
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Published on: 2022-03-04
Updated on: 2024-01-19