Patient Brokering: How We Got Here

Patient brokering did not start overnight. This page explains what it is, how it grew, the cases that exposed it, and where the law stands today.

1. What patient brokering is

Patient brokering is paying someone, or being paid, to send a person to a treatment center, sober home, or lab. The payment can be cash, free rent, a plane ticket, gift cards, or drugs. The person being sent is treated as a source of insurance money, not as a patient. [1][2]

The people who find and move patients are often called "body brokers." They are usually paid per person. [3]

2. How it grew

Insurance began to cover addiction treatment.A 2008 federal law, the Mental Health Parity and Addiction Equity Act, generally bars health plans from putting tighter limits on substance use treatment than on other medical care. [4] Under the Affordable Care Act, all Marketplace plans must cover substance use services as essential health benefits. [5] More people had coverage for treatment, and that coverage became a target.
Sober homes are housing, not treatment.People in recovery are protected by federal fair housing and disability laws. [6][7] In some states, such as Florida, certification for sober homes is voluntary. [8] Brokers have used sober homes as a place to hold patients while a treatment program bills their insurance. [2]
Recruiters are paid per patient.In one New Jersey federal case, treatment facilities paid about $5,000 to $10,000 for each person referred. [9]
Free rent and free flights.Recruiters have offered free or reduced rent, gift cards, drugs, free flights, hotel stays, and cash to get people to enroll. [2][3]

3. Landmark cases

Florida.Florida first banned patient brokering in 1996 (chapter 96-152, Laws of Florida). [10] In July 2016, at the Legislature's request, the Palm Beach County State Attorney formed the Sober Homes Task Force. [11] In 2017, Florida passed HB 807, which raised brokering penalties and added rules for addiction treatment marketing. [12] That same year, sober home and treatment center owner Kenneth Chatman was sentenced to more than 27 years in federal prison. Prosecutors said he paid kickbacks, gave residents free rent and drugs, and forced some women into prostitution. [2]
Southern California.In October 2026, federal prosecutors in Los Angeles charged four people in a scheme that billed private insurers more than $1.6 billion for sham treatment. The Justice Department called it the largest sober home fraud case it has ever prosecuted. These are charges, not convictions. [3]
Arizona.Fake or poorly run sober homes and clinics billed Arizona Medicaid's American Indian Health Program for care that was not properly given, while mostly Native people were housed in unsafe places. [13] Reported losses run up to about $2.5 billion since 2019. This is a reported estimate. [14] The Arizona Attorney General has brought many indictments, including 22 at once. [15] The Blackfeet Nation in Montana declared a state of emergency after members were left stranded in Arizona. [16] The Navajo Nation's Operation Rainbow Bridge estimates 5,000 to 7,000 Native patients were affected. [17]

For more cases by state, see the Policy page.

4. Where the law stands

Federal.The Eliminating Kickbacks in Recovery Act (EKRA), 18 U.S.C. § 220, became law in 2018 as part of the SUPPORT for Patients and Communities Act. It makes it a crime to pay or receive kickbacks for referrals to recovery homes, treatment facilities, or labs, including when private insurance pays. [1]
Florida.Florida's Patient Brokering Act is Fla. Stat. § 817.505. [10]
California.Health and Safety Code § 11831.6 bars licensed or certified treatment programs and their owners and staff from giving or receiving anything of value for a referral. SB 1228 added that rule in 2018. [18][22] Section 11831.65 limits when they can offer discounted housing or free travel, and requires a return ticket for any flight they provide. [19]
Arizona.A.R.S. § 13-3730 makes patient brokering for sober homes and treatment facilities a felony. [20] SB 1308, signed in 2025, amended that law and Arizona's sober home licensing rules. [21]

5. Why PBPI exists and what has to change next

The National Patient Brokering Prevention Initiative (PBPI) is a national public health campaign founded by Sequoyah Marie Thiessen. She has spent years on this issue, and much of what PBPI teaches comes from what she has seen on the ground, not only from research.

Trust.Survivors need to be able to trust police and other institutions enough to come forward.
Tell your story once.Survivors should be able to report one time and have it reach the right agencies.
The trafficking hotline gap.In PBPI's experience, people who call the National Human Trafficking Hotline about brokering are often turned away, because brokering usually is not treated as trafficking under the law.

General information only. This is not legal or medical advice. Rules vary by state, county, and city. Charges are allegations unless a court record shows a conviction or plea. Last verified November 2026.

Sources

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