NJ Teacher Busted in Prescription Drug Scam

Though many teachers have side gigs, one teacher in New Jersey decided to choose a highly entrepreneurial effort when he began recruiting public workers to take part in a multimillion dollar prescription drug scam. The 46-year-old man convinced a number of state employees to fraudulently get “compounded” medications like vitamin combos and certain creams. Those prescriptions were then sent into a pharmacy by the teacher and billed to the State Health Benefits Program.

The teacher and his co-conspirators each got a percentage of the profit. In total, the scheme cost the state about $25 million and garnered the teacher more than $350,000. In his plea agreement, he agreed to return all those funds and additionally pay more than $2.4 million in restitution. Of course, his ability to pay back that considerable sum will likely be negatively impacted by the loss of his job and future prospects as a teacher.

Scams, Insurance, and Addiction Treatment

Why does this matter to families who are facing addiction in New Jersey? Simple: money. Health insurance companies are notoriously difficult to work with when it comes to securing coverage for addiction treatment services. The burden of proof that any prospective treatment is “medically necessary” is not always an easy hurdle to clear. Many families find that they must compromise and enroll in a program that may not meet their needs because they cannot afford to pay out of pocket when the health insurance company refuses to cover more intensive treatment.

Fraud like this perpetrated by individuals and others has resulted in excruciatingly high health insurance costs, which translates into higher costs of medical care and ultimately higher costs for patients. As the current administration attempts to reduce healthcare coverage for mental health treatment services and addiction treatment services with each new budget proposal, it is an issue that families in New Jersey who have a loved one in need of treatment need to monitor closely.

Is DIY Addiction Treatment an Option

For many who are struggling to come up with the money to pay for a comprehensive drug addiction treatment program, it can be natural to ask the question, “Is addiction treatment really worth the money?” It can feel like treatment offers nothing more than a sober place where they don’t “let” you relapse, and that it is possible to provide this service to yourself or your family member at home without the price tag.

Unfortunately, when addiction is driving drug and alcohol use, trying to turn things around with willpower alone is simply not possible. If it were, it would have been done long ago. By the time they get to the point they are considering drug rehab, most people living in active addiction have tried a hundred different ways to manage the problem on their own. They may have tried to moderate their use by promising to use only certain substances, limit use to the weekends and/or evening hours, stop after a certain amount, etc. Many try to quit completely on their own and find that it just isn’t possible to sustain for more than a few weeks, days, or even hours. This is because addiction is a medical disorder, and as such, it requires medical treatment that is uniquely designed to meet their needs, address their personal circumstance, and help them meet their goals for recovery.

What Does Your Loved One Need to Get Started in Treatment?

For many people in active addiction, the financial cost can easily be blown up into a larger dilemma than it actually is, creating what feels like an insurmountable obstacle to treatment. The good news is that with a little bit of planning, drug addiction treatment does not have to be out of reach for any family despite the fact that an ongoing addiction can translate into financial crisis. That is, job loss and debt caused by legal problems, medical emergencies, and more are the norm, yet it is still necessary to prioritize treatment whenever possible. Without it, those financial issues will continue to stack up, worsening the problem and making it that much more difficult to pay for treatment.

Do you have questions about managing the financial aspect of addiction treatment?