HARRISBURG — Drug rehabilitation centers across Pennsylvania can’t expand services due to regulatory barriers, but they also face another challenge: repetitive audits.
The result is reams of paperwork and many hours lost to fulfill state and federal rules — but without the benefits of better accountability or transparency of how taxpayer money gets spent.
Advocates for the rehab centers aren’t opposed to the principles of audits, but they do raise their concerns over the time and money required to complete so many of them.
“Nobody would argue that there should be no audits,” said Jason Snyder, director of substance use disorder treatment services for the Rehabilitation and Community Providers Association. “What we’re saying is: There are so many audits done by so many entities that oftentimes are so redundant that there’s gotta be a better way to streamline all of these audits.”
Some health care providers, he noted, could be subject to 10 or more routine audits annually.
For example, if a provider accepts Medicaid patients, they would deal with a Managed Care Organization. Pennsylvania has five MCOs that cover different parts of the state.
If a provider has facilities across those zones, they’ll have five annual audits to complete. The Department of Drug and Alcohol Programs is a statewide regulator, which audits providers to ensure they follow applicable laws.
Single County Authorities, which divvy out DDAP funds to providers, will also require audits of how grants and other money gets spent by providers.
If a provider has more than one facility, they could face multiple reviews from MCOs, DDAP, and SCAs.
“The time it takes to prepare for and host these audits is time taken away from clinical services,” Snyder said. “When we’re already under pressure and stress because of limits in our workforce, to have to pull folks away for these audits time and time and time again just adds additional burden and really takes away from the focus of the provider — which should be on helping the patient get better.”
Getting audits right is crucial to protect patients and taxpayers alike. When oversight fails, the consequences get costly.
A facility in Camden, New Jersey, was fined $3 million for a Medicaid fraud and kickback scheme in 2022. Another rehab center outside Austin, Texas limited care to increase its profit margins. Oregon auditors raised transparency concerns over how $300 million for addiction recovery services were getting spent.
Pennsylvania has had its own trouble with other drug treatment facilities, such as some run by Addiction Specialists, leading to a federal investigation after the company violated state rules and had a wrongful death lawsuit filed against it.
The lives at stake, and the public and private money spent for recovery services, makes it crucial for audits to be useful in identifying problems before they get bigger, but also not over-burdening good-faith actors.
The RCPA wants to see the Department of Human Services and DDAP streamline some audits to avoid duplication and make the process easier. Snyder argued state officials need “a great sense of urgency.”
