By the time I walked up to Integrity Recovery Center’s front door, I’d been trying to get a hold of the owners for months.
Integrity’s website described the treatment facility as a “healing sanctuary” and showed photographs of a gleaming white mansion with a pool in the Los Angeles foothills. The place looked a little dingier in person, with trash in the driveway and weeds growing over a retaining wall.
Months earlier, I had gotten a call from the editor of Curbside Chronicle, a street paper that provides people in Oklahoma City experiencing homelessness with employment and other services. He had heard stories about Curbside clients who were getting free trips to California for drug treatment. I wanted to know: Who was paying for these trips? Why California? I started talking to people who had made the trek. They told me about people they’d never met offering free treatment, housing and transportation if they agreed to sign up for a Blue Cross and Blue Shield of Oklahoma insurance plan.
Federal law makes it a crime to offer compensation or gifts to go attend a specific treatment facility. It also prohibits treatment providers from promising free treatment as a way to recruit clients. Integrity was one of at least a dozen California treatment providers I heard stories about.
I eventually met Dustin and Yolanda, a couple who traveled from Oklahoma to California for substance use treatment at Integrity. A friend helped them get signed up for a health insurance plan with Blue Cross Blue Shield of Oklahoma. The federal government subsidized about $1,000 a month in premiums for the couple. They told me about a three-day car ride where they detoxed from fentanyl in the backseat while a woman they’d just met with a suspended driver’s license drove them to California. While staying at Integrity, they said they had little individual therapy, watched movies about recovery and were sent to stay at a sober living home where people were selling marijuana out front.
Integrity advertised a 24/7 crisis hotline number with the message: “Recovery starts with one call.” But the number connected to a recorded message trying to sell medical devices. None of the people who were listed in California records as the owners of the facility returned my calls. Showing up at the front door to ask for an interview in person seemed like it could help convey how serious we were about the story.
Before I could ring the doorbell, a man swung the large door open. He looked at me silently, so I introduced myself and explained why I was there. He said he’d have to ask management, and pulled out his phone to make a call. I peeked behind him as I waited. I didn’t see any clients or other employees, just a typical workplace bulletin board on the wall behind him with posters on workplace safety, and the sound of a TV floating through the otherwise empty and darkened foyer. He told me management didn’t want to answer any questions.
I felt deflated as I walked back to the car. I’d hoped for something. Yolanda and Dustin deserved answers about their own care, but it seemed like Integrity would keep dodging questions.
Before we published the story, I sent the owners of Integrity a letter via certified mail with my questions. But they never responded.
Staying in contact with people who went to treatment was another challenge to telling this story.
After treatment providers billed their insurance plans, many clients disappeared back to the streets. Many of the people I spoke with lacked permanent addresses or phone numbers. It was hard to keep in touch with them to ask follow-up questions or help them get their insurance records to show how much money treatment providers had made from their care.
Some people described a sense of desperation to get off the street. Others said they needed to get into a rehab to meet court or family obligations. Many had tried to navigate treatment locally without success. If the rehab was willing to get them the right insurance, cover housing and give free treatment, then they were willing to try it. Some told me that after their insurance stopped paying out, they were booted out on the street and told to use drugs again so they could get back into treatment. Others said they were left stranded with no way back to Oklahoma.
To tell the full story, I needed to know more about how treatment providers were profiting. Dustin and Yolanda agreed to help me get their insurance records. But they often switched phone numbers and had no permanent address. They don’t have a car, so they’d take the bus or walk to meet me for interviews. We caught them when we could to ask questions.
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Become a donorWhen the records finally arrived, they showed various treatment providers had billed their insurance more than $440,000 over the course of their roughly four-month stay in California. Blue Cross Blue Shield of Oklahoma paid out much less than the total, but Integrity still received over $60,000 for the couple’s care.
Insurance providers and law enforcement have started cracking down, accusing some treatment providers of health care fraud in court. Blue Cross Blue Shield of Oklahoma sued Integrity, a medical billing company and several other treatment providers in federal court this August, accusing them of submitting about $20 million in inflated or fake charges to insurance. Integrity has not yet responded to the allegations in court.
The day we published our story, the U.S. Department of Justice announced that it had arrested Nathan Young, who owns several treatment centers, and several others in connection with a $2-billion scheme for fraudulent medical claims to public and private health care programs after luring “vulnerable individuals to California for sham substance use treatment.” Many of these individuals were recruited from Oklahoma, the lawsuit alleges. These programs weren’t connected to Integrity.
Nearly two years after they returned from treatment, Dustin and Yolanda are doing their best to stay sober.
Blue Cross Blue Shield of Oklahoma has changed its out-of-state coverage policy to keep people in state for care, but we’re not done with our reporting. Now I’m investigating the ways that some California treatment providers have targeted members of Native American tribes.
If you have traveled to California for substance use treatment, please reach out. You can contact me at kayla@readfrontier.com or at 405-274-5430.
Kayla joined The Frontier in 2021. She covers social services, energy and the environment. She can be reached at kayla@readfrontier.com