The Massachusetts attorney general’s office is investigating a far-reaching insurance scheme that recruited drug users and sent them to treatment centers in other states to exploit their benefit payments, according to people contacted by the office and others familiar with the matter.
Jillian Fennimore, a spokeswoman for Attorney General Maura Healey, confirmed the office is conducting a criminal investigation of addiction treatment scams, which have proliferated amid the national opioid addiction crisis. She would not provide details of the probe, including whether particular entities or individuals were being targeted.
The investigation follows reporting by STAT and the Boston Globe on a national network of insurance fraud that preyed upon people desperate to break their addiction to opioids.
Many were sent to treatment centers hundreds of miles from home for expensive and often shoddy care paid for by insurance benefits obtained by using fake addresses. Patient brokers are often paid as “marketers” by treatment centers to sign up patients with private insurance plans.
The families of two Massachusetts men who died in Florida after allegedly being sent there for treatment by patient brokers are among those who have been contacted by investigators in the attorney general’s office. In both cases — detailed by STAT and the Globe in May and July — brokers or their associates allegedly helped the men obtain private insurance benefits and paid for them to fly to Florida for treatment.
One focus of the investigation appears to be the way in which insurance benefits were obtained for the patients sent out of state, according to people familiar with the matter.
Peter SanAngelo, of Malden, Mass., died of a carfentanil overdose last fall in Delray Beach, Fla., where he was allegedly brokered for treatment using a Capital Blue Cross insurance plan purchased with a phony Pennsylvania address. He was 33.
His cousin Samantha Herring said she has been contacted by Massachusetts investigators.
“With the anniversary of Peter’s death approaching, it is of course my greatest hope that the people who were involved in this are held accountable,” she said.
SanAngelo had been homeless and jobless in July 2016 when he was offered free insurance and luxury rehab that he hoped would rid him of his decade-long dependence on heroin. A sober life with his 4-year-old son suddenly seemed possible. He jumped at the opportunity.
Text messages on his phone, obtained by the Globe and STAT through Herring, laid out the scheme that brought him south. A broker signed him up for insurance using the address of a Pennsylvania sober house where he had never been, and then someone else bought him a plane ticket. Shortly after he got to the treatment center, however, his Blue Cross policy was canceled for nonpayment. He got a job managing a Florida sober house, and relapsed.
On the morning of Oct. 16, 2016, police found his body slumped in the driver’s seat of a van that belonged to the sober house where he worked. He was alone, with a needle in his pocket.
Investigators have also contacted the family of Patrick Graney, according to a person with direct knowledge of the communications.
Graney spent about two months in south Florida in the summer of 2016 after an alleged broker offered him free insurance and a free plane ticket.
The 30-year-old from Milton, Mass., who had first tried OxyContin at a high school dance and later graduated to heroin, relapsed just a few weeks after he arrived. He left treatment to sleep on the beach for a period before returning to the facility.
But by late August, the insurance plan purchased for him had been canceled. By early September, he was back out on the street.
Graney’s mother was trying desperately to get him home, and made plans to buy him a bus ticket.
Graney didn’t make it. He checked into a hotel room on Sept. 9 with two strangers he had met during a failed attempt to get into a detox center. Just after 2 a.m. on Sept. 10, he overdosed on cocaine and died. The Greyhound he was supposed to take to Boston left 10 hours later.
In a statement, Healey urged anyone victimized in a drug treatment scam to call her office’s Health Care Helpline at 888-830-6277 or file a complaint online at www.eform.ago.state.ma.us.
“It is critical that people struggling with addiction can safely access treatment services,” Healey said. “Unfortunately, those seeking to make a profit off of this epidemic are targeting vulnerable patients with illegal treatment and recovery scams.”
The attorney general’s office also indicated it is taking a broader look at sober home operators in Massachusetts. Sober homes offer group living for people in recovery from drug addiction. Healey’s office said it was looking into allegations of poor living conditions in some sober homes, false advertising, and the failure of some operators to maintain a sober environment.
Evan,
Thank you for your investigative reporting into the for profit “addiction treatment” industry. I would love to find a reporter in CT to tell my story. I did not die, but I am left with a cognitive impairment and memory loss.
I have anxiety and was prescribed a benzodiazepine FDA approved for anxiety. When my physician took long term medical leave I was shockingly unable to find a MD in my area to prescribe Lorazepam. Physicians would prescribe one week or two weeks of medication. That is absurd. I can not go to the MD every week or two weeks and by the way it is overbilling of Medicare. I was aware abrupt termination of Lorazepam causes a host of complications including seizures and possible death. After going to multiple MD’s and being unable to get the prescription I have been taking for years I went to Hartford Hospital and was told take one pill a day for three days. The medical advice took me from 6mg a day to 3 mg a day in three days. The FDA Lorazepam states “slow titration over weeks or months depending on the dose and the length of time on the medication” I had a MD appt on Monday. Prior to my medical appt I began losing consciousness. I called 911. At Windham hospital I lost my ability to speak, walk and had a massive seizure. Over the next 4 days I was brought to the ED by ambulance 5 times in extreme distress. Abrupt termination of Lorazepam (per the FDA) causes dysreflexia or autonomic dysregulation-dysregulation of the Central Nervous System. Dysregulation of the Central Nervous System. My blood pressure went from 120/80 to 220/120 a medical emergency called hypertensive crisis a medical emergency. They refused to treat me. After 5 days in and out of the hospital I was brought to Nachaug. I had worked in medical sale for Johnson & Johnson Neurosurgical and pharmaceutical sales for Pfizer Neurological. I had never heard of “Nachaug”. I begged to leave, this was not a normal hospital. They wanted to give me drugs to “treat” me. From working for Pfizer I requested the FDA overview of the medication(s). They refused to provide me information the very foundation of informed consent. They refused to provide me the (3) medications I have taken for over 5 years prescribed by my MD who I have been seeing since college 20 year ago. After 3 days the MD came to speak to me about my “doctor shopping”. This term “doctor shopping” is something I had never heard of but is used to imply a person is prescription drug seeking. Well shit. You got this all WRONG!!! I was looking for a doctor because my doctor took medical leave!!! Shocked I called my pharmacy and had them fax my prescriptions to Nachaug. I was released the next day. Nachaug is chaotic, disorganized and understaffed. I was unaware of what medications were in the little white cup and they refused my request for FDA literature. Released from Nachaug after 4 days I had a nervous breakdown that night. I was brought to another hospital and kept 10 days. The next hospital did bloodwork. There was nothing in my system except the medication given to me at Nachaug.
Medically Necessary under Medicare is what is needed to diagnose or treat a condition or disease. What was medically necessary was a ($3) prescription for lorazepam. Instead of the $3 prescription Medicare was billed $70,000. I have been to two Neurologists and a Neurologist who specializes in Epilepsy. I am having seizures now. Lorazepam has FDA indications for anxiety and seizures. I have lost my memory. I have a BS in business and worked for some of the top medical, surgical, pharmaceutical companies in the world. Now I can not remember my password to my e-mail, my bank, Hulu. I can not answer my phone because bill collectors haunt me day and night. I have pieced this together and Nachaug took me off medication indicated for anxiety and put me on medication not indicated for anxiety and contra indicated for persons with seizures (provoked seizure w/abrupt termination of lorazepam) contraindicated for persons with tachycardia (my heart was up to 110 BPM resting)
I saw patient brokering. I saw inhumane conditions. Nachug is a 50 bed “rehab” in CT fiscal year 2017 $50 million.
I am shocked and horrified this happened to me. I would love to find an attorney and hold this healthcare system responsible. Attorneys have said “not enough harm” and “too difficult to prove causation of brain injury and memory loss from hospital negligence”.
Nachag gave me in discharge papers: Treatment for Benzodiazepines (Elsevier) “Treatment for patients who wish to get off a benzodiazepine is a slow taper over weeks or months. Often treatment includes a prescription for a long lasting benzodiazepine (Valium) and the dose is reduced slowly over weeks or months. (Same information as recommended by the FDA slow taper)
SEEK IMMEDIATE HELP:
1. If you lose consciousness.
2. If you have a seizure.
3. Difficulty breathing.
4. Mental confusion
Day 1. I was brought to hospital losing consciousness, then a seizure at the hospital. Day 3. Crushing pain in my chest and unable to breathe. Day 4. Call 911 I was (mental confusion) incoherent, rambling, unable to stay on track to answer ambulance questions. My sodium and potassium had dropped so fast and so law it was life threatening.
Hartford Healthcare (Hartford, Widham, Nachuag) was fully aware of the dangers of abrupt termination of a benzodiazepine, fully aware of slow titration but chose PROFIT over known risks to my life, my health. I am the other face of this horrific lust for profits and unbridled greed. I am happy to share this information with you in hopes of preventing this from happening to another person. Please let me know if you have an affiliate in CT. I always told my daughter “beauty fades brains last forever” She is graduating from Rutgers University with her BS in a few weeks. I am embarrassed to see her. She can not comprehend I have lost my memory.
Please let me know how I can help expose the non addicted persons mistakenly caught in this deplorable system of greed.
David you know the real problem that we found years ago. No accountability or oversight of contracted services that Baker and his Democratic and Labor Boss allies plied in the 1990s. Remember Baker was the founder of destroying the state delivery system of providing services in favor of uncontrolled vendors, providers, and consultants. First as Assistant then Secretary of Human Services, then as head of Administration and Finance. The destruction of the delivery system started under Governor Dukakis and his Secretary of Human Services Phillip Johnston then Baker perfected it under Weld/Cellucci. Good to see you back. You and I witnessed so much Waste, Fraud, and Abuse in needed taxpayer dollars over the years but could not stop the carnage to those needing services and the taxpayer.
Michelle it’s sad to see your brothers death continuously exploited by hack tabloid writers who have a history of ignoring facts and twisting the story to suit the political agenda they serve. The AG probe they’re just announcing now is in fact old news. When is ellection time again?
Peter was my brother. No investigators made any attempt to speak with my family here in Massachusetts. Also Peter was found with no keys in the ignition of that van and there was a package of narcan prescribed to someone in the van with one gone. That van was backed into a strangers driveway. If my bother was going to shoot up in that van he would not have done it in some random driveway facing the street so people could see. The police said there was nothing suspicious about how my brother was found. They called the place the van belonged to from the scene and told them bring the keys and just let them take the van and leave. I guess dumping a body in Del Rey is a ok thing to do. Everything about the scene was suspicious. Shame on them for treating my brother’s life as nothing and never investigated anything about how he got there. The police report and medical examiners report both say the detective said nothing was suspicious about how a person drove with no keys started dying and narcaned themselves. They didn’t even question the guy who’s name was on the narcan