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How to Fight the Opioid Epidemic and Reduce Insurance Fraud Through the Utilization of Tax Credits for the Treatment Industry

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How to Fight the Opioid Epidemic and Reduce Insurance Fraud Through the Utilization of Tax Credits for the Treatment Industry

How to Fight the Opioid Epidemic and Reduce Insurance Fraud Through the Utilization of Tax Credits for the Treatment Industry

The best option for every family fighting a substance use disorder is going to involve getting people out of harm’s way and into the care they need. Getting a high quality care though is becoming gradually difficult to obtain and very expensive for individuals and the families too. There are a lot of reasons for this failure of an entire branch of our healthcare system but the most significant one is the combination of insurance fraud and the insurance companies’ reaction to that fraud either. Florida State Attorney Dave Aronberg wrote an excellent op-ed for Time in which he covers fraudulent exploitation of the "Affordable Care Act" by human traffickers masquerading as substance use disorder treatment providers http://time.com/4950199/affordable-care-act-opioid-relapse/. A very Poor funded agencies have been no match for the scale of this insurance fraud which has led to a critical failures when we really need each aspect of the system firing on all cylinders to take on both the opined epidemic and our larger substance use disorder and mental health concern crisis in this country. There exists a myriad of ways in which this fraud happens but one of the simplest to understand is pseudo facilities illegally buying insurance policies for uninsured individuals. This often comes alongside additional criminal acts in the form of inducements such as airplane tickets waving of deductibles and waving of out of pocket maximums required by insurance providers. Unfortunately with the sole exception of Florida states have to put substantive legislative safeguards in place for vulnerable families or enforce the ones already on the books. This process has been further slowed and made more dangerous for those seeking care as legitimate providers nationally have been deterred from advocating for corrective action by the onslaught of negative press that fighting for and making protections for families has brought down on the legitimate treatment industry in Florida. The insurance companies response to this fraud has been to increase out of pocket costs for desperate families year after year and decrease coverage for legitimate treatment providers right alongside the traffickers pseudo facilities to make up for their losses. By doing so they have  created a dynamic in which more families are willing to break laws to access what they believe to be behavioral healthcare and more people are ending up in pseudo treatment facilities. Even fixing the problem in Florida has yielded limited results as enforcement of laws and protections for families do little good if the traffickers just divert individuals to pseudo facilities in any of the 49 states where such protections don’t exist yet. The human traffickers specifically target insurance policies with higher reimbursements to fraudulently purchase for their victims that have been diverted from the legitimate behavioral healthcare industry. This criminal behavior going unchecked of course triggers even more drastic responses from the insurance industry which in turn results in even more families backed into a corner where access to quality care looks inaccessible. The most catastrophic of all the fallout from this downward spiral has been big insurers pulling out of entire markets which were  targeted by these human traffickers.

When it is absolutely critical to get every single person with a substance use disorder off the streets and into substance use disorder treatment because the increased lethality of a fentanyl laced opioid supply that is only getting stronger due to diversion and misuse of buprenorphine for the purpose of “bridging” https://www.huffingtonpost.com/entry/dying-to-get-high-medication-barriers-for-opioids_us_59d3c7c5e4b08c2a000ddc48 bureaucratic barriers to inpatient treatment are pushing up the death toll. Major efforts are underway in the public sector to remove Institution for Mental Disease exclusions and increase access to inpatient care systems that provide the foundation for longer term solutions but most importantly higher levels of safety http://www.addictionpolicy.org/single-post/2017/06/23/The-House-Introduces-Bipartisan-Legislation-to-Repeal-IMD-Exclusion. While these efforts are a huge step in the right direction they are insufficient to address the sheer scale of the crisis at hand.

One immediate solution would be the utilization of tax credits in the private behavioral health treatment industry to treat uninsured individuals. Governments small and large in our country regularly utilize tax credits for everything from filming movies in their region to moving jobs back and forth between Kansas City Missouri and Kansas City Kansas. Over 300 million dollars in tax credits and incentives were given on just that one squabble between just those 2 states last year. seriously do you really know what else happened in the same timeframe? It became harder for families on both sides of the Kansas City state line to access desperately needed treatment for their children with substance use disorders. Tax credits are a particularly easy way to pay for things on which you don’t want to spend money. If tax credits are particularly well structured during their design phase they can even be sold to companies in other larger industries that have enormous tax liabilities for a reduced rate. You may ask is any of this necessary? Because in the midst of a national emergency where 60,000 people a year are dying from opioid overdoses alone our leaders still can’t find money for anything substantive to address this problem. We are happy to spend $50,000 to $75,000 per year per inmate to incarcerate sick individuals for nonviolent drug charges if we catch them but we can’t find Lady Liberty’s pocket change when millions upon millions of desperate American families year after year are begging for help. I get that we are still stigmatized. I get that you don’t think we are worth saving. I get that those in power on both sides of the aisle still hate people with substance use disorders because for all your lip service that’s what your inaction
apparently communicates to a battered nation. I’m just hoping that you hate taxes even more than us because we need to get a million people off the streets before they end up in body bags and clearly this is one quick way to do it.

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