The Kiloby Center for Recovery is proud to be a member of the Independent Coalition of Treatment Providers (ICOTP). ICOTP is a group of treatment providers that works to maintain appropriate legal and ethical standards in the area of addiction treatment and that are working together to help rid the addiction treatment field of certain abuses that are damaging to the system and that may eventually drive up the cost of health care and negatively affect access to needed health insurance for those suffering from addiction. Visit icotp.com for more details.
The mission statement of the ICOTP is as follows:
“We believe it is time for families, providers of quality care and the payer community to support the United States Justice Department in a thorough investigation and indictment of those abusing the system. These abuses are defrauding insurance companies and wasting necessary resources needed for quality care and required under the Affordable Care Act.”
The purpose of the ICOTP is two fold:
“The first reason is to address some abusive practices by some that are draining resources needed for successful treatment. We are all aware of treatment providers involved in these practices. Unfortunately, the payers of addiction treatment (insurance and government agencies) and the public have no way of separating the “good guys” from the “bad guys”, and we all are stained by the bad guys. This severely hinders any efforts at working directly with payers to provide effective long-term treatment standards that have been proven to work. Our coalition is working directly with the Joint Commission to develop a “Clean Hands” pledge of ethical, sound and legal treatment practices that are transparent and verifiable. This Certification will signify to payers and to the public that a center bearing the certification meets these standards of sound and ethical practices. Allowing payers to firmly identify those centers that are providing sound and ethical treatment is very attractive to them and promotes good faith proposals to be developed to achieve our mutual goal of sustained and affordable recovery in a rapidly changing payer environment.
The second purpose of the coalition is to show payers how they can save money yet have increased success in addiction treatment by using a long term care strategy that has been proven to work. We all are aware of the tremendous proven success of treatment programs for licensed individuals such as physicians and pilots. These programs enjoy around a 75% five-year success rate, far greater than we see with any other traditional programs. The methods have been proven to be successful for physicians, pilots and some court systems, and these methods can be directly applied to non-licensed individuals that we treat every day. This five-year success involves some specific components. The first is an interventionist that enrolls and educates families in a way that can provide accountability. The interventionists stay involved for the full five years keeping the families on board, in essence providing ongoing leverage similar to what a licensing board provides physicians and pilots. The other components of this program after an initial intervention include an integrated 90 days of treatment for medical, psychological and addiction issues, strong aftercare planning that continues after this initial 90 day acute stabilization, and continuous random drug screen monitoring for five years. Payers are showing great interest in morphing the successful and proven professional programs into a program applicable to many others with addiction issues. Our work directly with the Joint Commission is also of great interest to the payers providing them a level of confidence in what they are paying for in a credentialed center.”
In addition to being a member of the ICOTP, the Kiloby Center for Recovery has a team devoted to maintaining and strengthening practices and procedures designed to assure quality care infused with strong ethical and legal standards. This team includes our Director, Scott Kiloby (who is an attorney), other retained attorneys with expertise in appropriate ethicial and legal standards for health care, as well as a medical billing specialist team with decades of experience. Scott Kiloby has given public lectures and has advised other treatment centers on ethical practices related to insurance billing.
Within the first two years of formation, Scott and his team have worked hard to employ certain practices that help to avoid abuse of the system. These practices include:
- Sound legal and ethical standards relating to the payment or waiver of out-of-pocket expenses and other co-pays.
- Billing practices that avoid double billing, over-billing and other insurance billing fraud.
- Collection efforts that help insurance companies feel comfortable that clients are helping to pay uninsured costs, when they have the means to do so, and that help clients feel comfortable that their insurance companies are paying what is owed under their policies and what is needed for their particular treatment plan.
- Legal and ethical practices to avoid illegal kickbacks to outside individuals or entities. The Center has a policy against fee-per-client kickback schemes where a dollar amount is paid or received in reference to a particular referral.
- Procedures that help protect against clients taking certain actions that are abusive to the system. This includes procuring insurance just for the purposes of treatment and then dropping the insurance immediately after treatment or failing to pay premiums during or after treatment and other procedures that help protect against similar fraudulent practices with regard to the procurement or maintenance of health insurance. The Center employes a “preconceived plan” assessment so that clients officially state in writing that they have no preconceived plan at the time of admission to take any such actions.
- Procedures that allow clients to have appropriate choices with regard to referrals to doctors and other health care professionals, when additional treatment outside the scope of the Center’s program is needed.
- Adherence to standards set forth by JCAHO, an independent Joint Commission designed to help treatment centers employ quality standards of care and ethical practices. The Center is in the process of seeking accreditation from the Joint Commission.
- Adherence to state regulations for addiction treatment centers. The Center is certified as a Day Treatment and Outpatient Center by the California Department of Health Care Services.
- Employment of a long-term recovery plan that includes initial intervention when necessary, suggested 60-90 days of treatment, and an extensive aftercare plan. Clients who follow and complete this long term plan have a much higher success rate. In the end, this saves the insurance companies money as clients do not have to seek subsequent treatment because of chronic relapsing.
If you have any questions about the Center’s policies as stated herein, please contact us at info@kilobycenter.com
