How to Choose an Ethical Treatment Center

After reading this site you might wonder if there are any good treatment centers out there.  We are here to assure you that there are many amazing and ethical programs to be found, but how does one find them?

Sometimes it’s all about asking the right questions.

Here are some questions to ask as well as some items to consider when calling a treatment center for yourself or your loved one.

It can be useful to know who owns the treatment center in question as well as what OTHER treatment centers do they own? 

Fraud in this industry tends to get noticed and a simple Google search will go a long way to help you search about programs after knowing who their owners are and what they own.

Any ownership interest in a lab/testing facility by a treatment center or staff person at a treatment center creates a huge conflict of interest, and possibly a violation of the Stark Law.

This would also be a big red flag for UA testing because it would be likely that the client’s insurance will be billed for excessive UA tests.

There exists a massive corruption in the UA testing arena surrounding addiction treatment.  We are seeing new examples [ link ] of this every day.  In a typical residential treatment scenario, a client might be UA tested at intake with a complete toxicology report to determine what substances they have taken.  Throughout treatment follow-up tests are rarely needed more than once per week except when substance use or medication irregularities are suspected. 

Often UA testing gets billed out to insurance for exorbitant fees and is conducted on a highly frequent basis; making it a profit center for the treatment agency. Even toxicology labs partake in kickback money for treatment centers who send their UA testing to them to be billed large fees by the labs.

These are unethical scenarios and they abuse an already taxed health care system. 

It’s not an ethical problem to mark up a diagnostic test to cover the cost of materials, testing, and staff to administer it, but there’s a difference between charging $900 (when the lab charges $6 for the dip panel and $25 for the lab result)  for a simple dip panel confirm lab test, when $75 or $100 would be far more reasonable and appropriate. 

It is illegal in many states, and is unethical in all of them, to accept fees or to pay fees to anyone for the referral of a client.  This is, in essence, Body Brokering.

While accreditations are not a guarantee of ethical behavior, organizations such as CARF and Joint Commission require a center to undergo a rigorous process to be accredited by them, and this can at least be an indication that the organization has a defined set of policies in place. 

The licensing and certifications of the staff at the treatment center ought to be sufficient to provide the services they are claiming to offer.

For instance, most states have certifications for drug and alcohol treatment counselors (case workers) and some even require specialized licenses for that job.

Anyone treating co-occurring disorders ought to be a licensed mental health professional (LMFT or LCSW or equivalent). 

This can be a vital question, and you may need to be direct with it when speaking to them.  There are many “call centers” that pretend to be treatment centers.  They get paid to send your inquiry to a treatment center that pays THEM to get the call.

This kind of arrangement is not necessarily a problem, on the face of it, but it creates situations where callers are often sent to “highest paying bidders” rather than actually appropriate treatment centers for the presenting problem. 

In addition, those answering the phone are often not clinically qualified to provide competent screening and assessment necessary to determine what center is the best fit for your loved one. 

OFTEN there is a treatment center near you that is appropriate, where a call center may end up sending your loved one a thousand miles away to a center paying the call center for business. 

Here are a few other items that you’ll want to pay careful attention to while finding treatment for yourself or your loved one:

Flights & Other Inducements – A particularly shady practice, a treatment center will entice you to go with them by providing a free airline ticket to get the patient there. This inducement is illegal in most states and unethical in all states.  

Free Sober Living Beds – Some unscrupulous centers will charge the client’s insurance for PHP or IOP  (both outpatient levels of care) benefits while giving them free sober livings beds. This, also an inducement, is unethical and often leads to outpatient programs “pretending” to be residential programs.

Waved co-pays and deductibles – It is fraudulent for a treatment center to make it a habit to waive co-pays or deductibles. The are rare instances of financial (documented) need where this sometimes happens, but it also violates agreements between the client, the center, and the insurance company. 

Appropriateness of Care (co-occurring) – There are treatment centers out there that advertise that they specialize in co occurring disorders, while providing only certified (or less) counselors. This constitutes a scope of practice problem.  Co-occurring disorders require treatment by medical and licensed clinical personnel.   If a treatment center claims a specialty (LGBTQ, Trauma, Pain management, etc.), ask them to tell you how they provide those services.

Bogus Google Ads – There are some instances where you might have heard about a good treatment center and you google it to get the # and call. Be careful to get the right place as there are instances where call centers and unscrupulous treatment centers are paying for “keywords” of the names of reputable centers to get you to click on them instead.