The recovery community has known for years that housing insecurity is one of the greatest obstacles to an individual’s ability to battle addiction.  Additionally, Medicaid reimbursement rates for residential substance use disorder (SUD) treatment programs are insufficient to cover the staffing and regulatory costs of providing residential or facility-based care.  Across Minnesota, dozens of treatment programs have responded by enhancing their intensive outpatient programs (IOP) and worked to help clients find safe and stable sober housing.  However, all too often those providers fail to adequately contemplate the way state federal healthcare law may impact their efforts.

For example, some IOP providers have sought to provide some kind of housing voucher to clients that would offset the costs of an independent or third-party sober home.  This is despite the fact that this practice has been called into question and prosecuted as a violation of the federal Anti-Kickback Statute since at least 2016, most notably by the United States Attorney for the Southern District of New York.  In Minnesota, what was becoming a common practice, has recently been at the center of a high profile fraud investigation.  Other providers have elected to build or acquire their own sober living settings and make them available to clients and below-market rents.  However, absent a Housing Supports contract with the local county to cover the costs, these arrangements may prove just as problematic.

Going forward, licensed SUD treatment programs should closely examine any housing assistance programs it might employ to ensure compliance with state and federal anti-kickback laws as well as the federal prohibition on beneficiary inducement.