Editor’s note: This story was produced in conjunction with the Curbside Chronicle. Read the story in print in the November edition.
Yolanda and her husband Dustin packed enough fentanyl for the drive to California to avoid getting sick on the road.
One week earlier, a friend the couple called “Pumpkin” told them about a treatment program where they could get new clothes and stay in nice homes. Federal law makes it a crime to offer compensation or gifts to attend a specific drug treatment program. Violators can face up to 10 years in prison and $200,000 in fines. Pumpkin told them everything would be free, the couple said. They just needed to sign up for an insurance plan with Blue Cross Blue Shield of Oklahoma.
Pumpkin told Yolanda that she had just come back from treatment in California herself. Now she and her daughter helped recruit people to Integrity Recovery Center, Dustin said. The pair would help the couple get to California by arranging insurance and coordinating their travel.
Yolanda and Dustin had both used drugs for years, and were chronically homeless in Oklahoma City. Dustin is nearly blind. Yolanda had tried a different rehab several years earlier. Now, the potent fentanyl showing up in the city scared Yolanda. It seemed like a good time to try sobriety again.
A week later, a woman who worked for the California program arrived in a silver Chevy truck to drive them the nearly 1,400 miles west to Los Angeles.
But the woman had a suspended driver’s license. Police pulled the trio over south of El Reno. Yolanda managed to toss her drugs before police found them, but she got a ticket for possession of paraphernalia. Dustin, growing more concerned about their trip, wanted to call friends to come pick them up and take them back to Oklahoma City. Yolanda, ready to end her fentanyl addiction, took the battery out of his phone.
The truck was impounded. The couple stayed at a motel that the California detox facility paid for, Dustin said. The next day, family friends helped the driver get her truck back, and Yolanda and Dustin finished the three-day trip in withdrawal in the backseat. One clinician told The Frontier that severe dehydration can make it dangerous to detox from fentanyl without medical supervision.
“It was fucking hell. But I knew it was going to be worth it,” Yolanda said. The Frontier is only using Yolanda and Dustin’s first names because they feared potential legal consequences from accepting free insurance and treatment.
Dustin and Yolanda spent the next week in detox at Integrity Recovery Center — a mansion with room for six patients in the foothills that ring the San Fernando Valley in Los Angeles. When they eventually had group-style therapy sessions at an outpatient treatment program run by a different provider, many were over Zoom.
Integrity is one of dozens of drug rehab facilities in California where hundreds of Oklahomans have sought treatment in the last several years with the promise of stays in luxury housing and treatment near the beach paid for by private insurance plans that were sometimes subsidized with federal funding. Recruiters known as “body brokers” referred people to these programs and helped sign them up for health plans, sometimes targeting people with little income who lacked permanent housing.
Blue Cross Blue Shield of Oklahoma sued dozens of providers, including Integrity, and the medical billing company CodeMax in federal court in August, claiming the programs fraudulently signed people up for insurance and transported them to California for treatment. The lawsuit claims that the providers never planned to collect payments from these clients, and instead submitted “inflated, fake charges” to reap more than $20 million in insurance payments. The case is still pending, and CodeMax and Integrity had not yet responded to the lawsuit by the middle of October. CodeMax did not respond to requests for comment.
Integrity did not respond to requests for comment or written questions. A reporter visited the Integrity detox facility in Los Angeles in June. An Integrity staff member said management did not want to answer questions.
Six Oklahomans who attended treatment at various California programs over the last five years told The Frontier there were few therapy sessions. Many said the help offered was mostly in the form of group meetings run by case managers or people who were recently clients themselves. Some said providers abruptly told them to leave facilities after their insurance plans stopped payments. Two said people working with their provider told them to go out and use drugs again so their insurance would pay for more time in a detox facility.
One mother is suing multiple treatment providers for wrongful death after her son died of an overdose at a residential facility in 2024. Another Oklahoma mother told The Frontier that her son died of an overdose while in treatment at a California rehab program in 2019.
Insurance subsidies fuel wave of rehab recruitments
Dustin and Yolanda qualified for a government-subsidized health insurance plan through Blue Cross Blue Shield of Oklahoma. The insurer described itself as having “robust out-of-network, out-of-state benefits,” in one lawsuit.
The couple said they didn’t fill out any insurance forms themselves. Five other Oklahomans The Frontier interviewed who attended various other California treatment programs said someone else signed them up for Blue Cross Blue Shield of Oklahoma insurance or told them what to write on enrollment forms.
The couple said they gave all of their information to their friend Pumpkin, and she handled the rest. The Frontier tried to locate Pumpkin but was unable to find her.
Dustin and Yolanda weren’t sure what income information was submitted on their behalf. They hadn’t had permanent jobs in years, records show, and Dustin gets monthly disability payments. But they were approved for federal subsidies to offset the cost of a monthly insurance premium for one of Blue Cross Blue Shield of Oklahoma’s private health plans. Dustin’s subsidy covered about $570 in monthly premiums, while Yolanda’s covered $630 per month, insurance records show.
The Biden administration introduced federal subsidies in 2021 as part of the American Rescue Plan stimulus package, making private health plans cheaper for people who made too much to qualify for Medicaid but too little to comfortably afford insurance. Someone making around $21,000 a year could sign up for an insurance plan on the health care marketplace and get some or all of their monthly premium subsidized by the federal government. Oklahoma’s Medicaid plan does not usually cover out-of-state substance use treatment.
California substance use programs began recruiting clients from at least two Oklahoma homeless shelters, offering help to sign people up for insurance plans through Blue Cross Blue Shield of Oklahoma that would cover treatment. Other people said they were recruited through social media or recommendations from friends. Five people experiencing homelessness who are also vendors for Curbside Chronicle, Oklahoma City’s street paper, said they traveled to California.
April Doshier, who was executive director of the homelessness service provider Food and Shelter in Norman at the time, said people began calling her office around 2023, saying they could help clients find substance use treatment that would be covered by their health insurance.
It seemed strange that the only options the agents discussed were facilities in California, Doshier said, but treatment beds were difficult to find in Oklahoma. An insurance plan someone could get “for usually nothing” that would cover the costs at a facility that said it had a bed seemed like a good deal, Doshier reasoned. A few clients took the agents up on the offer and had good experiences, Doshier said. Food and Shelter began recommending the option.
In late 2024, Blue Cross Blue Shield of Oklahoma sued California-based provider South Coast Behavioral Health and an insurance agent in Oklahoma, among others, alleging that the provider had fraudulently received over $36 million in payments after using recruiters to find people in need of treatment, arranging their travel and enrolling them in insurance plans using false information about income, employment and residency. South Coast Behavioral Health agreed to pay the insurer $20 million in September to settle the case, and the claims against the other defendants were dismissed.
Around the same time, Food and Shelter clients started contacting Doshier for help, saying their rehab programs would kick them out because insurance would no longer pay, Doshier said. Food and Shelter paid to get one man signed up for a new insurance plan that would continue to cover his rehabilitation program. They bought bus tickets to try to get other people home.
Federal agencies have accused insurance brokers of fraudulently enrolling people in the plans, promising people cash or gift cards for personal information, and falsifying personal income information on enrollment forms to get approved for the cheaper plans. In Blue Cross Blue Shield of Oklahoma’s lawsuit against Integrity and other providers, the company claims patients were enrolled in plans a week before their treatment began. The subsidies expired at the end of 2025.
Blue Cross Blue Shield of Oklahoma has since restricted coverage of out-of-state treatment across multiple of its insurance plans. The company declined to answer questions, citing pending litigation.
Two other major insurance companies, Aetna and Health Net, a subsidiary of Centene, have also taken legal action against Southern California treatment providers, accusing them of recruiting clients with patient brokers, offering free housing and failing to collect patient copays.
A tangled web of providers and therapy over Zoom
It was evening when Dustin and Yolanda arrived at Integrity Recovery Center on March 20, 2024. Photos from Integrity’s website, which is no longer functional, showed gleaming white stone floors and modern art on the walls. A white baby grand piano sat in the living room, and a large pool overlooked the green Los Angeles foothills. Integrity’s website described it as a “healing sanctuary.” Yolanda said it was the nicest house she’d ever stayed in.
Integrity staff reported to Blue Cross Blue Shield of Oklahoma that Dustin and Yolanda were experiencing severe withdrawal from fentanyl and would need ongoing treatment, according to insurance company records. The pair shared a room, and staff prescribed six medications to help with their withdrawal symptoms. Integrity told Blue Cross Blue Shield that the couple’s treatment plan would include safe detoxification, medication management, group and individual therapy, discharge planning, relapse prevention and follow-ups with a physician.
But Yolanda said the treatment she remembers during their days at Integrity was mostly medication management and staff checking on them occasionally. There were no group sessions, she said. Integrity wrote in notes it sent to Blue Cross Blue Shield of Oklahoma that Yolanda and Dustin were too sick for group sessions. The couple slept and “sat around and watched TV,” Yolanda said.
Blue Cross Blue Shield of Oklahoma records show the couple’s stay at Integrity lasted about a week. Integrity billed insurance about $119,000 total for the pair. Blue Cross Blue Shield only paid a fraction of those charges, leaving over $82,000 in deductibles and other costs that Yolanda and Dustin could be asked to pay out of pocket. The couple says they were never asked to pay anything.
California state law and federal law make it a crime for treatment providers to promise in advance to waive a person’s out-of-pocket costs to recruit them into treatment.
Integrity opened as a residential drug and alcohol treatment facility in early 2024, a few months before Yolanda and Dustin arrived. The company is owned and operated by Hovhannes Tshavrushyan, a former accountant and trucking company CEO who helped start three drug rehabilitation programs over the last three years. Tshavrushyan is also the director of an assisted living facility, according to filings with the California Secretary of State.
Yolanda said Tshavrushyan, who went by Hovo or John, was at the house occasionally. Tshavrushyan and other staff asked multiple times whether she and Dustin knew people in Oklahoma who needed treatment that would come to California, Yolanda said. She and Dustin talked with a few friends, but none made the trip. Yolanda said they never received any payments in exchange for talking with friends. Tshavrushyan did not respond to multiple requests for comment.
The California Department of Health Care Services investigated Integrity in 2025 after a complaint of patient brokering — recruiting patients to a specific facility in exchange for payment. But the investigator wrote that staff and clients at the facility said they hadn’t gotten any payments for bringing people to or agreeing to come to the program, and the complaint was closed.
Brian Couey, a longtime clinician and executive for mental health treatment programs in California and Oklahoma, said it’s difficult to prove patient brokering or insurance fraud because providers can create networks of businesses that don’t seem connected. Providers find clients, bill insurance under different facility names and hire former clients to help recruit new patients.
“That’s the three-pronged approach,” Couey said. Their actions can be on a spectrum of “unethical to illegal.”
Yolanda and Dustin spent the next two months bouncing between outpatient providers, sober living homes and Integrity. Yolanda said she believed Integrity coordinated the sober living homes they stayed in, and she and Dustin weren’t required to pay rent. Many people who finish inpatient treatment live at sober living homes with roommates who are also staying sober as they continue outpatient care. Oklahomans who went to California for treatment said how helpful a sober living home was depended on who lived there and who managed the house. In one house, the couple said they saw people using and selling marijuana.
Three main treatment providers, Integrity, Jewel City Treatment Center and Clear Path, billed their insurance during this time, writing in requests for insurance authorization that they would provide services like group and individual therapy, grief counseling, peer recovery and medication management.
Yolanda and Dustin said they spent time in group therapy sessions and watching hours of virtual classes on stress management and coping skills. In 2024, California health rules allowed some outpatient providers to provide telehealth services with no limits on the size of the group, as long as they still meet state requirements for providing enough hours of treatment, said a spokeswoman with the California Department of Health Care Services.
One Oklahoman who attended treatment in 2024 at a different California program said he knew the offer of free treatment and housing was “too good to be true,” but he felt like he had no other options. The treatment was mostly Zoom calls with hundreds of other people logged in, he said.
Yolanda and Dustin said they met dozens of other people who were from Oklahoma. They had in-person classes to attend, Yolanda said, but the clinicians they worked with “just weren’t into it.” They’d put on movies about recovery for them to watch, she said. They did art therapy and yoga and had Narcotics Anonymous-style meetings talking about how to improve relationships with family. Sometimes they’d go to the beach on weekends.
Jewel City Treatment Center, one of the outpatient programs Yolanda attended, has an office on the ground floor of a beige building lined with palm trees tucked off one of the main streets in a shopping district in Glendale, 10 miles north of downtown Los Angeles. A sign for the company hangs on a door at their listed address, but no one answered when The Frontier visited in June. No listed numbers for Jewel City Treatment Center work, and the company doesn’t have an operational website. The California Department of Health Care Services said the company shut down in late 2025. The agency investigated Jewel City in 2025 for client brokering, but did not find any evidence to support the complaint.
Integrity shared several key staffers with Jewel City. Arno Khachatrian was the program director for Jewel City and was also an executive and a part owner of Integrity. The Frontier called, emailed and sent letters to Khachatrian with no response. The programs also had the same psychologist. The physician for both facilities was Dr. Eric Chaghouri. Chaghouri founded The Recovery Doctor, a business that provides doctors to rehabilitation programs across the country, according to its website. When Integrity opened, Chaghouri was listed as the program’s medical director, scheduled for 20 hours per week, according to the facility’s state license.
At least a dozen rehabs in Southern California list him as a staff psychiatrist providing direct care to clients or a medical director overseeing treatment. Chaghouri did not respond to phone calls or emailed requests for comment. Blue Cross Blue Shield of Oklahoma’s lawsuit against Integrity and other treatment providers claims that Chaghouri was listed as the attending provider for 15 different treatment programs that allegedly submitted fraudulent claims. The insurance company wrote in court documents that overlapping ownership helped the companies coordinate their strategy for maximizing payments from insurance.
No free trip home
After leaving a sober living home following a disagreement with the house manager, Yolanda spent a week wandering around downtown Los Angeles, alone, using drugs again, she said. At one point, Dustin was treated for an opioid overdose at a local hospital. Their treatment ended after another three-day detox stay at Integrity in July 2024.
Dustin was homesick. Yolanda said she had thought about asking to be a house manager for Integrity, but decided to go back to Oklahoma.
Yolanda told staff they were ready to leave and expected help with transportation to Oklahoma, which she said had been promised. But Integrity staff declined to help, she said. Instead, the pair waited for Dustin’s disability check to come in and bought bus tickets to Oklahoma City. Even without the promised free clothes or help getting home, the trip didn’t feel like a total loss, Dustin said.
“They did make some promises that didn’t come true,” Dustin said. “But, I mean, once we got out there, it did help us out.”
Back in Oklahoma City, they sometimes stayed with Dustin’s mom or camped with a friend near downtown.
Yolanda said almost two years later that they were doing their best to stay sober. She said she no longer uses fentanyl, but they still lack permanent housing.
Treatment providers billed Dustin and Yolanda’s insurance company for $440,000 during their time in California. Integrity alone submitted nearly $340,000 in claims. Insurance eventually paid Integrity over $66,000, and another $6,000 to other providers.
“I knew this all had something to do with money,” Yolanda said. “I don’t know if I convinced myself, or if I allowed myself to be convinced, that they actually cared about people, too. I don’t know. I think part of me thinks they did care. But obviously it’s a very nice money maker as well.”
