ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Saturday, December 14, 1996 TAG: 9612160047
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: TAMPA, FLA.
SOURCE: Associated Press
SOME THOUGHT they were going to a spa. But they ended up at psychiatric hospitals that committed them until their insurance ran out, a suit says.
Patients coming to Florida for treatment of problems with alcohol, food or relationships brought their tennis rackets and golf clubs, expecting leisurely stays at luxurious resorts or health spas.
Instead, they found themselves admitted to psychiatric hospitals, misdiagnosed and held captive until their health insurance ran out, major insurers charged in a lawsuit filed against a group of Florida clinics. Insurers charged the scheme cost them $39 million over five years.
Some patients ``who had no mental health problems arrived in Florida completely unaware that the limousine that met them at the airport was taking them to a psychiatric hospital,'' said the federal suit filed Thursday.
To discourage patients from leaving before their benefits were exhausted, return airline tickets were withheld, the lawsuit said. In one case, a patient was medicated to prevent his departure. In another, a couple's children were medicated.
The lawsuit names Largo's Sun Coast Hospital; Northpointe Behavioral Health System, also known as The Manors, in Tarpon Springs; Heritage Beverly Hills Hospital in Lecanto; and The Retreat psychiatric hospital in Broward County.
Officials of the facilities did not return calls or refused to comment Thursday and Friday.
The lawsuit follows two years of investigation by Prudential Insurance Co. of America and MetraHealth Insurance Co., formerly Metropolitan and Travelers, said Thomas Queen, a Washington lawyer representing them.
``The investigation revealed the practices, and the companies were appalled by those practices,'' Queen said. ``The companies are committed to identifying and combating health care fraud.''
Patients were recruited - one free-lance recruiter charged clinics $3,000 per patient - diagnosed with mental illnesses and treated based on their coverage rather than a psychiatric condition, according to the lawsuit.
It detailed 14 incidents, among them:
* An Ohio railway worker injured his neck and shoulder; but a union representative, who allegedly took a kickback, persuaded him to seek treatment in Florida for alcohol abuse.
The worker was given plane tickets and told his insurance co-payment would be waived. He found out later the Manors psychiatric hospital diagnosed him as depressed. He was told he would receive his ticket home only if he stayed for 30 days. The only treatment he received was massages.
* A New Mexico woman seeking treatment for an eating disorder was told she was going to a health spa.
She ``had no idea that she would be going to a hospital,'' the lawsuit says. At Heritage, there was no supervision of her diet, she received no counseling, and her exercise was limited to walks around the building.
``Although she had been promised a 30-day program, [she] was suddenly discharged after 15 days when Travelers stopped paying for treatment.''
* A husband and wife went to Horizon Hospital with their three children for ``family counseling,'' unaware that Horizon was a lockdown mental hospital.
The couple were separated, allowed only limited contact with their children and received no marriage counseling. Their two sons were diagnosed with major depression. Their daughter was diagnosed with an adjustment disorder with a depressive episode. Against their mother's wishes, two of the children were placed on medication.
* An Ohio man was admitted to Sun Coast for substance abuse after being arrested for possession of a crack pipe. The clinic paid for a one-way ticket, then told him he had to pay his own way home.
Sun Coast held him for 21 days until his benefits ran out, then flew him home. It billed his insurance $20,000, although he attended just one group therapy session, the lawsuit said.
LENGTH: Medium: 74 linesby CNB