A Baltimore Democrat is pushing a new bill to improve state oversight of drug addiction treatment centers following a series of stories by The Banner exposing unscrupulous practices by program operators.
The investigation, published in collaboration with The New York Times, revealed in December that for years, Maryland health officials barely vetted a flood of new addiction treatment programs despite paying hundreds of millions of dollars annually to serve the state’s poorest residents.
As a result, some patients ended up at what were effectively government-funded drug houses where many relapsed, overdosed and some even died, the investigation found. Now Del. Sandy Rosenberg wants to require health officials to provide yearly updates on what they are doing to fix things.
Rosenberg, a Democrat who represents Baltimore City, said he was upset to learn from the Banner/Times investigation that people who were supposed to be getting care were living in “horrid conditions.”
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“I read the article and said, ‘What can we do to enhance oversight so we don’t have this happen again?’ ” Rosenberg said.
The bill he introduced calls for the Maryland Department of Health to submit reports this year and next on how it is improving regulation of addiction treatment programs and recovery residences.
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In a letter to legislators, the department did not take a position on the bill, but said it has taken “extensive” steps over the past nine months to improve the quality of programs, including revising regulations, identifying Medicaid fraud and training local behavioral health authorities to improve oversight.
The proposed legislation unanimously passed the House of Delegates, but still must clear the Senate before it has a chance to become law.
Dr. Joshua Sharfstein, a professor at the Johns Hopkins University’s Bloomberg School of Public Health and a former state health secretary, said legislators should be tracking concerns around the quality of drug addiction treatment and housing provided to people in recovery.
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There are special challenges to addressing these issues, he said, because in many cases, treatment services are regulated by health authorities, while housing is not.
“I know the health department is committed to improving oversight, and I would expect there would be updates to report,” he said.
Nearly nine months ago, the state announced it was tackling suspected Medicaid fraud, waste and abuse at programs providing outpatient drug counseling services that oftentimes also offered housing, potentially as an incentive to draw patients into treatment. That combination could be a violation of state and federal anti-kickback laws, according to state health officials and legal experts.
The Banner/Times investigation revealed that addiction treatment provider PHA Healthcare placed patients in apartments that many described as poorly maintained and ridden with drugs and crime. At least 13 connected to the program died, including a 1-year-old boy who starved to death, according to the investigation.
PHA Healthcare’s owner, Stephen Thomas, has called the reporting “very unfair” and said hundreds of patients have had positive experiences with the program. In statements to the state, documents show, he has also denied that the housing was a kickback or inducement.
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PHA Healthcare was ordered by the state to stop providing treatment services in January but continues to house people who are struggling with addiction.
Del. Joseline A. Peña-Melnyk, a Democrat and chair of the Health and Government Operations Committee called the revelations in the piece “terrible and unimaginable” in a statement, adding that “continued oversight is essential to prevent these tragedies.”
Senate President Bill Ferguson said the state needs to look closely at why spending on treatment has spiked in recent years. He added that state government must also determine whether there are “bad actors” taking advantage of policy changes meant to expand access to treatment.
Sen. Clarence Lam, a Democrat who represents Howard and Anne Arundel counties, helps lead the Joint Audit and Evaluation Committee, which has reviewed audits of the state health department. Lam said it’s the General Assembly’s role to “stay on top of the health department and make sure they’re doing what they’re supposed to be doing.” If lawmakers continue to hear about problems, there may be hearings later in the year on the topic, he said.
“I’m not sure there’s been a full accounting in the General Assembly about what took place and how that was allowed to occur,” Lam said. “There needs to be accountability for this so we can prevent this from happening in the future.”
Banner reporters Meredith Cohn and Brenda Wintrode contributed to this report.
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