Previous reporting by the author of this piece also inspired a great episode of the Reply All podcast last week. [0]
Obamacare mandated that all insurance should cover rehab costs. Several rehabilitation companies opened an enormous amount of "clinics" in Florida. "Rehab SEO" companies then offered services to these clinics to funnel patients to them. Clinics could charge upwards of $5,000 per urine test from the insurance companies.
It became so profitable, that rehab companies would pay to fly patients down to Florida, pay $1,500 commissions to the SEO companies, and more.
This system of misaligned incentives resulted in the "rehab" companies to buy drugs for their patients, so that they would fail a drug test. This would allow them to "reset" billing for that patient. There is an anecdote from a patient describing one such clinic directly next to a crackhouse with prostitutes. Apparently many patients spent years rotating through these clinics because they had no other options (except maybe homelessness, due to their addictions).
Florida eventually legislated rules that prevented this behavior, which resulted in many of these "rehab" clinics moving to California.
More reporting on this system:
https://www.nytimes.com/interactive/2017/12/27/business/addi...