At a hearing this week investigating the addiction treatment industry's sketchy marketing practices, various industry representatives said they agreed that their peers need more regulation—but that their own business practices were kosher.
"We support the committee's efforts to clean up the practices that are harming us all," said Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers. He noted that trade groups usually lobby for less government oversight, but: "We do not do so in this instance."
"I do think we need federal intervention," said Michael Cartwright, chief executive officer of American Addiction Centers.
Members of the House of Representatives' Energy and Commerce Committee organized Tuesday's hearing as a part of their months-long examination of unethical practices among addiction treatment facilities. Oversight and Investigations Subcommittee Chair Gregg Harper (R-Mississippi) asked all the witnesses to take an oath to tell the truth, which typically only happens during investigative and confirmation hearings. All the witnesses agreed.
This hearing focused on call centers, which refer callers to treatment facilities, and which people frequently find by searching for addiction help online. News investigations have found that unscrupulous call centers refer patients to shoddy facilities—especially patients with private insurance that they can bill—and often hide the fact that they're paid by the treatment clinics to do so. Journalist Cat Ferguson found that the companies involved in the care of one call center user billed her insurance more than $3,600 for a urine test, for which Medicare reimburses less than $80, and nearly $75,000 overall for 11 days of alcoholism treatment.
Those who try addiction treatment numbers listed online "have a right to know what type of facility they're calling and what treatment is offered," Committee Chairman Greg Walden (R-Oregon) said.
Some witnesses at the hearing suggested the companies they represent have made changes that Congress wants to see, but only very recently. The National Association of Addiction Treatment Providers updated its Code of Ethics in December and has kicked out dozens of members since. American Addiction Centers, a company headed by one of the other witnesses, was one of those expelled, for not branding its ownership clearly enough on the websites it owns, Ventrell said. And American Addiction Centers only started paying their call center workers salaries, instead of compensating them based on commission, on July 1st.
The National Association of Addiction Treatment Providers has developed a guide to help consumers assess how likely a treatment center is to offer quality care, Ventrell said during the hearing. One of its suggestions is to avoid generic websites and call centers that place people in treatment. "Many of these make referrals based on business relationships instead of a patient's best interest," the guide says.
It's a fad now for patients, doctors, and politicians to say "addiction is a disease," akin to chronic ailments such as diabetes, but when it comes to seeking treatment, many still don't treat it as such, Harper said during his opening statement. Normally people with a complex medical problem would go to their primary care doctor, who would refer them to a reliable specialist. It's of course possible for people with addictions to do the same. Yet, when it comes to addiction, "individuals seeking care for themselves or a loved one often turn to the Internet to find resources to guide them in choosing a treatment center," Harper said. "Patients are often at the mercy of what they find online, with little or no guidance from a medical professional."