Massachusetts AG launches probe of addiction treatment fraud

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.

Read more: The addict brokers: Middlemen profit as desperate patients are ‘treated like paychecks’

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.

Read more: Desperate for addiction treatment, patients are pawns in lucrative insurance fraud scheme

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.