Home Publisher's Note Pay-to-Play
Publisher's Note
Pay-to-Play
July 2007

While putting together this month’s Special Report: Therapeutic Schools, we came across some seamy professional practices that are quite common among therapeutic schools and wilderness programs, and also practiced in the treatment industry, but we believe to a lesser extent. The practices we are referring to are something we call Pay-to-Play, but what are more commonly known in the medical business as Pay-for-Patient. These practices, which involve paying referral sources for patient flow - in the case of therapeutic schools it’s usually to educational consultants and in the treatment business it’s often to interventionists - are definitely illegal when Medicaid and Medicare are involved. But in the private-pay world that the therapeutic schools, and now many of the private treatment centers, live in, the legality is murky and varies from state to state. And there are plenty of ways around any law, like, for example, when an interventionist who refers large numbers of clients to a center later gets invitations to give lectures there at $5,000.00 a pop. But we have also heard of payments that are much more straightforward than that, like certain supposed independent interventionists that may actually have been on the payroll at some centers. Now, there might not necessarily be anything unethical about Pay-to-Play if the process were transparent, like if payments were known to all parties - patient, family, provider and consultant alike. But that is not sometimes what is occurring, with interventionists, educational consultants and others marketing themselves strictly as advocates for patients, and often paid by them, while also quietly acting as paid marketers for providers. And so you have strong disappointment among clients like Robb and Debb Holub - who have recently started a program that doesn’t pay for patients, like, we should say, the vast majority of programs - when they suspect that monies may have been exchanged with their son’s treatment. Such practices are seamy in the extreme, and a major blot on our industry.

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