Kirti Reddy Writes Article for American Health Law Association Titled “Addiction Treatment Schemes Targeting Homeless and Native Americans Forcing Systemic Changes”

Quarles & Brady Partner Kirti Reddy wrote an article for the American Health Law Association about Arizona uncovering one of the largest behavioral health fraud schemes in the United States that targeted homeless individuals and/or Native Americans for fraudulent substance use treatment.

Reddy, co-chair of the firm’s Government Enforcement Defense and Investigations team, explained that the fraud fell into two major categories: fraudulent billings by behavioral health treatment providers and patient brokering (referring patients to addiction treatment providers in exchange for payment).

An excerpt:

In 2023, Arizona uncovered one of the largest behavioral health fraud schemes in the United States. The scheme targeted homeless individuals and/or Native Americans for fraudulent substance use treatment. Organizers of the scheme bribed victims by providing them housing in unlicensed “sober living” homes. They also enrolled victims into Arizona’s American Indian Health Program, even if they were not Native Americans. The victims were then sent to behavioral health treatment centers, not for the purpose of receiving proper treatment, but simply so that the treatment centers could bill for services to the Arizona Health Care Cost Containment System (AHCCCS). The fraud fell into two major categories: (1) fraudulent billings by behavioral health treatment providers and (2) patient brokering (referring patients to addiction treatment providers in exchange for payment).