Another hustle. “This is predatory.”

51T1SeT4LRL._SX345_BO1,204,203,200_Alcoholism and Drug Abuse Weekly (ADAW) posted an article that describes the system used by a Florida treatment program to fill beds with insured clients as an out-of-network provider. They want out-of-network admissions because they do not come with managed care restrictions. ADAW describes their approach as “not unusual for the field.”

The fact that virtually all Banyan patients have out-of-network insurance is by design — out-of-network insurance is the best kind from the provider’s point of view, as there are no cost limitations based on contracts. The main referral source is in Illinois, where Tim Ryan operates as Banyan’s Midwest regional outreach coordinator, a full-time salaried position. Ryan told us that he refers people with good insurance to Banyan, because that’s his job.

. . .

The vast majority of patients Ryan, who has no clinical credentials, refers to treatment have no insurance. He has a not-for-profit that, according to Banyan and Ryan, is independent of his work for Banyan, called the Man in Recovery Foundation. Through this, he attracts people who need treatment.

. . .

Ryberg [an industry consultant] grew up in the area of Chicago where Ryan is operating, and got sober there. He has heard about the Man in Recovery Foundation’s “outpatient groups,” which are used as recruiting mechanisms for patients. “In no way, shape or form does the job they do resemble a typical clinical outreach representative in the industry,” he said. “They’re not clinical, and they’re not sending clients to the appropriate level of care based on need. This is predatory.”

 

The Chicago Tribune ran a similar story months ago:

Ryan heads a Naperville-based nonprofit dedicated to aiding people with drug problems, but he also has a job marketing a $15,000-a-month rehab center in Florida. The line between those roles is blurry to some critics, who say it could create a conflict of interest.

. . .

The for-profit rehab, which opened in 2013, is one of hundreds of treatment centers in the state. Like many others, it follows the so-called “Florida Model,” in which patients receive therapy at a clinic but live in offsite apartments.

The arrangement allows patients to stay much longer than the typical 28 days of inpatient care, said John Lehman of the Florida Association of Recovery Residences. Low costs and substantial insurance reimbursements have turned such treatment centers into a lucrative business, he said, and many market their services far beyond the state’s borders.

That strikes a nerve with some Chicago-area rehabs — “I find it hard to believe that people need to leave this immediate area in order to get very effective and caring service,” said Pete McLenighan of Joliet’s Stepping Stones Treatment Center — but Banyan owner Joe Tuttle said leaving home can be good for someone seeking sobriety.

“We’re selling (the idea of) getting away from your environment,” he said. “If your friends are using, you’ll probably be using, too.”

Since joining Banyan 15 months ago, Ryan said, he has referred more than 100 people there, some of whom he met through his charitable work. Such an arrangement strikes some in the recovery community as problematic.

What’s the consequence of this?

“The sad thing is, someone sees a TV show [Ryan was recently on Steve Harvey] or a video [Ryan has several], and they make that call,” said VanDivier. “It’s an uninformed panic-stricken consumer out there, and that’s what these guys take advantage of.”

John Lehman, president of the Florida Association of Recovery Residences, told ADAW that lack of education among patients and family members is the systemic problem. “They go Google, and boom, they make a decision,” he said. “As an industry of ethical operators across the country, we should be building an infrastructure that supplants their SEO methods and gets them to a site that educates them on the levels of care, on the appropriate care for the individual, how you go about choosing a program,” he said.

That reference to SEO reminds me of this post and a conversation I had with a rep for program that had something like 6 boutique treatment sites and some ridiculous number of websites to market them.

What will the long term consequences be? It’s hard to know for sure, but I’m pretty certain that it will damage the reputation of all treatment providers (residential, in particular), damage the public perception of recovery, and give insurers reason to clamp down sufficiently indiscriminate manner that will make it more difficult for everyone to access higher levels of care.

I don’t know anything about Tim Ryan or Banyan Treatment Center. But, I do know there are a lot of hustlers out there. Many of them are well-intentioned and want to do good and make a little money at the same time. Unfortunately, many of these people, for a variety of reasons (some financial, some personal) end up in ethically troubling places.

8 Comments

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8 responses to “Another hustle. “This is predatory.”

  1. Watch 20/20 tonight and in weeks to come. There will be reports that details the abuses that have become endemic to the field.

  2. Kevin

    What is the point of this “post” except to try to create some controversy? It’s a couple of paragraphs attached to excerpts from other articles, one very much out of context.

    Tim Ryan is authentic as they come when it comes to helping others achieve recovery. He’s been through circumstances are truly hard to comprehend. If he was hiding his relationship with Banyan it would be an interesting discussion but it’s very much out in the open and fully disclosed.

    Recommend you use your time and talent to meet Tim and document outcomes that can be replicated. Take a little time to do some research, learn a little about his background and story and you will better understand why he is uniquely positioned to help others – whether it’s through his foundation or Banyan.

  3. The sad thing, Kevin, is that there is so much corruption and graft, whether it is patient brokering, drug testing or billing fraud, forgiveness of deductibles and copays, incompetent commissioned call centers and, of course, that oxymoron of all oxymorons: NON-MEDICAL DETOX. Let’s see, the patient needs detox but, that level of licensure does not allow the use of medications nor medical staff. Unfortunately, though, the vast majority of these programs, do use medications, just not medical staff, all in violation of their low level of licensure for acute detox cases. The State Dept. of Health in California, cannot even explain what constitutes non medical detox, and their nine investigators, lack the training or time to investigate the surge in this form of programming. If you refer to ASAM’s patient placement criteria, you will find that these programs should only be admitting meth addicts that need to sleep off their last run or marijuana dependent patients that need to be kept out of the refridgerator. They are not, per ASAM standards, to admit psychiatrically unstable patients, medically unstable patients or patients with histories including alcohol, benzodiazepines, opiates or other sedative drugs.
    Unfortunately, the patient who calls the call center is promised anything that will get them to pay the thousands of dollars to be admitted, thus getting their commission. Our experience, is that call center staff have a tendency to tell you anything that you want to hear and have no problem telling potential patients or family any number of lies. Try it. Call the latest, greatest program that is going to save your life that pops up on your computer screen and ask them if they can get you off of that ten milligrams of xanax that you’ve been taking for six years and the heroin for two. How long will it take? According to the call center three to five days, but you need to stay for 90 to insure your “recovery”. Why do you think that there have been so many deaths in treatment and that a patient leaving a 30 day treatment program has a 75x’s greater chance of overdose death, than does the inmate leaving prison or the person, who just stays on the street.
    Jason and I don’t agree about everything but, on this one, he is right on and if the industry doesn’t clean itself up (which is highly unlikely), the state and law enforcement will. It’s already been too long and too many have died because of the amount of money, greed and corruption that has taken over a field that I used to be proud to of.

  4. Kevin

    All comments are probably accurate and valid – the point is that singling out a person and posting their name in a half baked “article” with little factual support or even a comment from the person being singled out is not an appropriate way to start a constructive dialogue.

    If the author, Jason Schwartz, wants to start a productive discussion he ought to take the time to speak to the subject of the post and get his comments in order to present a balanced view. After citing an article in the Chicago Tribune, completely out of context, he states that he does not know Tim, has never spoken with Tim. The article referenced, was posted on the front page of the Chicago Tribune and portrays completely different context than is implied above.

    The author has an opportunity to correct this (and really owes it to Tim) by reaching out to him to learn a little about his approach, what he’s been through, and what he does to help others on a daily basis. Then the author could post a follow-up – I would enjoy reading Jason’s follow-on. Tim’s contact information is well publicized so this would not be complicated.

    • I’m not a journalist. I just share news of interest to my staff and readers and provide some commentary/analysis.

      As I said in the post, I don’t know Banyan or Ryan, but what’s described in the article is consistent with troubling behavior that is currently happening among addiction professionals and treatment programs.

      You’re calling out the ADAW and the journalist who wrote the article. Can you explain how it’s half-baked?

      As for the Chicago Tribune article, my quotes from that article were not completely out of context. In fact, the next paragraphed says he has a conflict of interest. The article did say he has a lot of fans, but it also raises questions about his “unapologetic flamboyance”, “mixing addiction with entertainment”, his “lack of professional training”, his “bombastic” style and his “unseemly love of the spotlight.”

      Both articles also quote him, so he did have a chance to get his side in.

      That said, I’ve been on the receiving end of biased reporting. He’s welcome to post a comment. If he’s got substantive corrections/context/explanations, I’ll add them as an update in the original post to make sure no one misses it.

      • Kevin

        Thanks Jason – I’m certain you didn’t intend for this to come off the wrong way and my comments were intended to be constructive.

        Addiction is a terrible disease and this is an individual who is definitely not in it for money – he lives recovery each and every day and is helping hundreds of people – the majority of which do not go to his employer.

        Strongly suggest you reach out to him as a phone conversation or hearing him speak would go a long way and a follow-up post would be appropriate.

        Wasn’t a direct subscriber to this (but might subscribe) – in fact, your post was automatically emailed to me (and I imagine many others) by a social network where I’m connected to him through one of his pages and hope you recognize that your post gets automatically distributed and it definitely came off as a one sided article/post.

        Best Wishes to you and your mission.

  5. I agree with you, completely. Perhaps, jason will choose to make that contact and gain further confirmation or a determination that the info. is less than accurate.

  6. I need to agree with Jason, that the Florida model of treatment is a farce. Essentially, they are using the federal fair housing act to circumvent any form of oversight for their sober living homes, while placing the individual varying forms of outpatient treatment. Why not, just put them into outpatient? Banyan, tries to make the case that patients need to leave their home community and establish recovery in a new “environment away from their using friends”. I believe, just the opposite, I think that addiction is not caused by your peers but, rather, that our peers are chosen because of our addiction. Banyans got it all mixed up. Study after study has shown that patient’s staying in their home community and beginning to get some hope that they can change the REAL problem (not their friends), but their dependency on some external substance to change the way they feel. It isn’t that we want to drink, smoke, stick needles in our arms. We want to go from point A to point B. From discomfort to greater comfort. That is, likely, different for everyone based on brain chemistry and other factors. So changing my environment, doesn’t change the fact that I still have this hole in my gut. How about, we get the patient together with their family and begin to look at the emotions that drive addiction. Afterall, why do we use? To FEEL better. If I can do that in my home community, than there is a seamless transition from different levels of outpatient treatment ie PHP, IOP and aftercare, all the while, making connections in recovery where I can find people who have discovered a new way of living. That is the point isn’t it. The more I read Jason’s post, the more I agree with the basic premise that the programs are designed to drive money into the pockets of the call center driven, out of network facilities. How do I know they are out of network? Because insurance companies won’t pay for the Florida model that has reared its ugly head the last decade. Now, put that together with detox, and a failure to create home based recovery connections, now creates patients who are being treated by lay people but with medications that they have no idea, how they work. Not a good recipe for sustained recovery.