How Acadia Is expanding Access to Lifesaving Care to Confront The Opioid & Substance Use Epidemic

As a national leader in Opioid Use Disorder (OUD) treatment, we take our responsibility to our patients and the communities we serve extremely seriously. We firmly stand behind our patient-centered practices and evidence-based approach that combines FDA-approved medication with counseling and other patient support services in voluntary programs, which is proven to be the most effective way to save lives and reduce the risk of relapse. Our programs are working and saving lives: across Acadia’s network of Comprehensive Treatment Centers (CTCs), an average of 72% of drug tests for illicit opioid use have been negative over the last five years, compared to research that shows relapse rates can be as high as 90% without treatment.

A recent follow-on news story on Acadia has made inaccurate assertions about our Comprehensive Treatment Centers and our approach to opioid treatment. The handful of past allegations and anecdotes cited in this story are either false or omit material context, and when cherrypicked and pieced together, paint an inaccurate picture of our standards, practices, and quality of care for our patients. We patently reject these claims, including allegations employees are pressured to enroll patients, falsify records or overbill for services.

Physicians and medical providers determine admissions based on medical necessity, and we comprehensively evaluate any person seeking help with OUD at any point in their treatment journey. In addition to treating individuals with OUD, many of our CTC facilities also provide a range of other behavioral health services and programs. In line with our core values, we will continue to provide evidence-based treatment to those who need it and to address our patients’ other needs by coordinating services within our local communities.

With thousands of well-trained and qualified employees, tens of thousands of satisfied patients, and hundreds of satisfactory audits and independent inspections, we are proud to meaningfully improve the lives of our patients. In our most recent patient survey, patients provided positive responses about treatment at our CTCs: For instance, 9 out of 10 CTC patients surveyed last quarter indicated they would recommend our program to others. And when asked to rate their improvement in quality of life since entering our program, we scored a 4.43 out of 5 (with a 4 representing “Good” and a 5 representing “Excellent”).

Here are the facts:

1. Acadia’s nationwide network of Opioid Treatment Programs (OTPs) is helping to expand access to safe and effective medication-assisted treatment (MAT), which is proven to save lives and reduce the risk of relapse.
2. Our clinics are all licensed, accredited, and regularly inspected to uphold high regulatory and quality standards, including rigorous requirements for admissions, billing, staffing and employee training.
3. Acadia’s policies strictly prohibit falsifying records; we regularly monitor the quality of documentation and accuracy of reimbursement and maintain a robust compliance program inclusive of independent third-party reviews.
4. Our programs are voluntary and follow medical and clinical best practices; counselors are not compensated based on the number of patients they see, and enrollment decisions are made by medical staff who are not financially incentivized based on admissions or patient visits.
5. Acadia prioritizes counselors spending meaningful time providing essential care services to patients – whether billable or not – because it helps to drive better patient outcomes.

Fact 1: Acadia’s nationwide network of Opioid Treatment Programs (OTPs) is helping to expand access to safe and effective medication-assisted treatment (MAT), which is proven to save lives and reduce the risk of relapse.

Approximately 100,000 people in the U.S. die from drug-involved overdoses annually, with 75% of those deaths involving an opioid. Yet – it is estimated that only one in five individuals with Opioid Use Disorder (OUD) receives evidence-based Medication-assisted treatment (MAT).

MAT is a cornerstone of effective, long-term OUD treatment. By addressing both the physical and psychological dimensions of OUD, MAT creates a holistic approach that reduces the risk of relapse, supports personal growth and fosters healthier relationships and life skills. In fact, research consistently shows that people who stay in MAT for extended periods are more likely to remain in recovery, reduce their illicit drug use, and experience improved health, employment and social outcomes such as increased employment rates, increased housing, reduced incarceration, and lower incidence of infectious diseases like HIV and Hepatitis C.

However, methadone is a Schedule II substance and has the potential to be lethal if not administered in a regulated setting by medical professionals. This is why it falls under DEA regulation. Finding a therapeutic dosage individualized to the patient is crucial, especially during the early stages of treatment. That is why, in addition to ensuring appropriate protocols as patients undergo treatment, we also implement clinical protocols that are designed to ensure that those patients who choose to taper from MAT are provided the opportunity to safely do so with informed consent and at a mutually agreed-upon rate that minimizes taper-related risks.

Our support for MAT is driven by safety and efficacy. Through our network of 165 Comprehensive Treatment Centers (CTCs) across 33 states, we are proud to support more than 72,500 patients in treatment. Acadia continues to play a leadership role in expanding access to robust MAT care, including via new clinics, mobile vans, telehealth and technology to streamline the patient experience. We have a centralized patient engagement and intake team available 24/7/365 for prospective and existing patients and we typically offer same or next day admissions to prospective new patients seeking treatment.

Fact 2: Our clinics are all licensed, accredited, and regularly inspected to uphold high regulatory and quality standards, including rigorous requirements for admissions, billing, staffing and employee training.

As with all Acadia facilities, independent third parties regularly visit our clinics – on both announced and unannounced visits – to ensure compliance with policies governing reimbursement and quality of care, including requirements imposed by government healthcare programs. The accreditation standards we follow are set by the accrediting bodies such as CARF International and are not unique to Acadia.

CARF International (formerly known as the Commission on Accreditation of Rehabilitation Facilities), a leading global accrediting body for OTPs, validated Acadia’s CTCs, with most recent annual CARF review of outcomes scoring in the 99th percentile across CARF’s 13 identified measures. 100% of our CTC clinics have received full accreditation, which is required by the Substance Abuse and Mental Health Services Administration (SAMHSA). Additionally, all CTC facilities are registered with the DEA, certified by SAMHSA and local and state governing bodies, and overseen by applicable state boards of pharmacy.

Since the beginning of 2020 we have successfully completed over 800 surveys conducted by the DEA, CARF, state boards of pharmacies, and other state regulatory bodies.

We are deeply focused on ensuring our CTC facilities are adequately staffed and supporting our employees with effective onboarding and training programs designed to ensure ongoing compliance with regulatory and clinical care requirements. Our staffing policies are designed to adhere to strict staffing requirements set by the individual state governing bodies, including maintaining appropriate staffing ratios.

We also monitor and adjust staffing levels as needed and have processes in place to fill vacancies and temporarily adjust caseloads if, for example, a counselor at a specific clinic resigns. While state-specific regulations around counseling ratios and counseling requirements vary meaningfully, our protocols are designed to consistently satisfy these regulations in all the geographies we serve. Patients remain in control of their treatment journey, and we are committed to harm reduction and ensuring their safety above all else.

Our counseling and clinical workforce consists of over 1,200 counselors and counseling supervisors and nearly 100 peer support specialists, case managers and community liaisons who provide additional wraparound support and clinical services that complement our counseling programs. Since 2021, the number of staff at CTC clinics has increased by more than 20%, and since 2022, our annual frontline staff turnover has declined by 13%.

Fact 3: Acadia’s policies strictly prohibit falsifying records; we regularly monitor the quality of documentation and accuracy of reimbursement and maintain a robust compliance program inclusive of independent third-party reviews.

Acadia’s policies strictly prohibit falsifying records. In fact, falsifying or altering company or patient records is a prohibited activity that could result in immediate termination as outlined in our employee handbook. In addition, Acadia has a Compliance Hotline, managed by a third party, for employees to confidentially, and anonymously if they choose, report any issues, including concerns about accuracy of medical records or billing. Any such reports are investigated, with appropriate actions taken as necessary based on those investigations’ findings.

Additionally, we make great effort to train and educate staff on how to chart accurately and follow rigorous billing guidelines set by the federal and state governments and various insurance payors. We provide and regularly update new hire training and orientation manuals for our staff, including job-specific training for counselors and billing staff. This includes comprehensive training for counselors that covers several topics, including evidence-based counseling as well as how to complete quality clinical documentation in the EMR. Our centralized billing staff also completes robust billing training.

Acadia’s CTC facilities’ policies require adherence to federal, state and payor billing requirements. Payor guidelines and frameworks like CMS’s annually published OTP billing guidelines for Medicare govern our billing processes. Similarly, state Medicaid and Managed Medicaid plans have fee schedules and billing requirements that we follow. Our commitment to compliance includes regular monitoring and adherence to state-specific Medicaid and Medicare billing rules to ensure our practices align with these established regulations.

In addition, Acadia has internal programs which regularly monitor the quality of documentation and accuracy of reimbursement. This includes quarterly chart reviews of a random sampling of patient records for each CTC clinic, which examines billing and reimbursement accuracy as well as completeness of documentation and compliance to individual payor and government billing requirements. CTC clinics also complete regular quality reviews to ensure the completeness and quality of their medical, clinical and administrative documentation, including a review of admissions and discharges.

To ensure appropriate internal controls are in place over financial processes, staff members are tasked with completing a daily review process of our “Services Rendered” which includes a review of counseling, drug screens, inventory, medication dosing/administration, and patient volume/census. As part of this process, staff are expected to complete several reviews to trace back clinical services to counselor’s notes or patient logs.

A third-party Independent Review Organization (IRO) reviewed a random sample of Acadia’s CTC claims and documentation for services provided from 2019 through 2024. The findings were highly favorable with an overall review score of 99.97% for the initial year reviewed, and a review score of 100% for the following four years, with no errors identified. As an added layer of control, Acadia has engaged the same firm to complete proactive audits of billing, coding and documentation quality for all CTC clinics going forward.

Acadia’s CTCs practice is to comply with pre-and-post payment billing reviews and medical record requests made by Medicare, Medicaid, other payors, as well as various government agencies. We regularly provide individual patient records to various payors and government agencies, upon their request, for those third parties’ internal billing and regulatory compliance reviews.

Fact 4: Our programs are voluntary and follow medical and clinical best practices; counselors are not compensated based on the number of patients they see, and enrollment decisions are made by medical staff who are not financially incentivized based on admissions or patient visits.

Acadia’s CTCs provide Medication Assisted Treatment (MAT) on a voluntary, outpatient basis, and our policies comply with the admission and intake criteria set by federal (SAMHSA) and state regulations and informed by the American Society of Addiction Medication (ASAM) criteria. These guidelines are widely used by healthcare providers including in the nonprofit and public sectors across the country and are not unique to Acadia.

Importantly, Acadia’s practice is that our physicians and clinic staff do not engage with any potential new patient until that patient has already decided they would like to seek treatment at one of our facilities and has initiated an intake appointment. Since treatment is voluntary, patients also have the flexibility to choose when to start or complete treatment.

At our CTC clinics, treatment decisions are guided by the patient’s goals, preferences, and clinical and medical needs, with input from a multidisciplinary team of healthcare professionals and clinic staff including physicians, nurses, counselors, clinicians, peer recovery specialists and case managers. CTC clinic staff continually engage with and assess patients to adapt customized treatment plans based on needs identified through various medical, clinical, counseling, and other direct care touchpoints. This ongoing interaction enables our medical and clinical staff to educate patients on their ongoing care and how to make informed care decisions.

We dispute allegations that Acadia has a corporate practice to instruct or pressure employees to enroll patients who do not meet our admission criteria and policies. Acadia takes compliance with our company policies and standards and code of conduct very seriously; conducts investigations into alleged violations of these policies; and takes appropriate action to respond to confirmed violations, up to and including employee termination, where needed.

The decision to admit or enroll a patient into our voluntary MAT programs is not up to counselors or clinic directors. Again, these are medical decisions made by physicians and medical providers based on standardized criteria set by federal (SAMHSA) and state regulations and informed by ASAM criteria. Compensation contracts for physicians and medical providers do not financially incentivize them based on admissions or patient visits. Participation as a MAT patient with OUD is not solely determined by drug screen results, as we focus on treating the whole person and helping patients achieve and remain in long-term recovery. As an example, someone who has OUD might test negative for illicit opioids if they are currently in withdrawal. Someone who was recently released from incarceration or is pregnant may test negative for illicit opioids but still have OUD.

Counselors are not compensated based on the number of patients they see. Additionally, our compensation practices for clinic directors are in line with director-level positions within the healthcare sector and take into consideration a variety of factors that prioritize quality, access, employee satisfaction, and patient experience to ensure we’re providing the best care to patients and the community.

Fact 5: Acadia prioritizes counselors spending meaningful time providing essential care services to patients – whether billable or not – because it helps to drive better patient outcomes.

We track time spent with patients, as counselors and clinicians are expected to spend a substantial portion of their time providing care to patients. However, we do not distinguish between time spent on billable and nonbillable services. We prioritize our counselors and clinicians spending meaningful time with patients and delivering essential care services because these interactions have proven to drive better patient outcomes.

This is a complex patient population with many patients facing co-morbidities including other substance use disorders and mental health conditions in addition to OUD. Our counselors are specially trained to deal with substance use disorders and put patient safety above all else. For example, when a patient does not want to receive counseling, our counselors are trained to work progressively with the patient to foster a therapeutic relationship and increase counseling and treatment engagement at a pace that is comfortable for the patient. Our multidisciplinary treatment teams prioritize safety and engagement because we know keeping patients engaged in treatment reduces the risk of relapse and overdose and improves their quality of life.

Keep in mind that many of the services we provide often exceed what payors will reimburse, including time spent on addressing social determinants of health (SDOHs) such as coordinating Medicaid-funded transportation, securing housing, helping to find employment, coordinating care in the community and calling to check in on patients. Acadia strongly advocates that 100% of opioid settlement dollars be used to directly address the country’s national health crisis by expanding treatment, supporting public health and addressing SDOHs which are often a barrier to treatment. Providing compassionate, patient-centered care is at the core of what our teams do every day.

Acadia remains focused on addressing our country’s opioid health crisis. Opioid deaths have dramatically increased over the last decade and fentanyl overdose is now the leading cause of death for Americans ages 18 to 45. Acadia is committed to improving access to care and providing the effective, supportive and compassionate care that is so desperately needed. Our staff clinicians who work daily to improve the lives of those who walk through our doors believe that providing comprehensive, evidence-based and long-term care for patients saves lives, restores families and reduces stigma.