According to a survey conducted last year by Behavioral Healthcare Executive, industry leaders believe that ethical standards should be enforced primarily by associations. The National Association of Addiction Treatment Providers (NAATP) is starting off the year with an updated code of ethics as well as a new pledge to enforce it.

Executive Director Marvin Ventrell says that NAATP is taking a bold step by making ethical business and clinical operations requisites of membership for the first time.

“The preamble states clearly that members must comply with all elements of the code so there’s no confusion,” Ventrell says. “As a condition of membership, they agree to be removed if they do not comply.”

Of course, the goal is not to exclude organizations but rather to drive compliance across the industry with clear expectations. Ignorance is no longer an excuse for crossing the line on ethics.

“We might get smaller before we get larger,” says Doug Tieman, president and CEO of Caron Treatment Centers and one of the architects of the NAATP code.

Tieman says the high road might not be easy and might lead to legal snarls along the way, but NAATP is prepared to defend its position. The hope is that members removed will ultimately comply and become members reinstated.

Marketing expectations

The most significant updates in the code address marketing tactics. For example, standards expressly forbid patient brokering or any form of remuneration for referrals.

“There is no buying and selling of leads—that needs to be said,” Ventrell tells Behavioral Healthcare Executive.

Guidelines for marketing also demand transparency about the center’s identity in terms of name, location, services, licensing, accreditation and staff credentials. Online directories, for example, must include each featured center’s direct phone number.

“There are sites that pose as directories or resources, when in fact they are feeder sites to a particular organization,” Ventrell says. “It’s not clear to the consumer because the center’s name isn’t even on the page. They think it’s a clinical resource that leads to the best treatment.”

Similarly, transparency extends to statements made about licensing. Centers must be clear about what type of treatment they are licensed for and in which states. According to Ventrell, the specificity is important for consumer protection, and it's no longer acceptable for treatment centers to gloss over their licensing details on websites and in marketing materials.

Tieman says too often treatment centers are justifying their own actions as ethical while judging their competitors as unethical. Now the code creates a common definition for marketing standards.

“The beauty of this is that we lay out ethical marketing behavior instead of allowing everybody to interpret it for themselves,” he says.

Patient protection

Using a patient’s testimonial, image or identity as marketing tool while the patient is still in treatment also is prohibited by NAATP. Testimonials are usually appropriate further along the recovery path—with the patient’s written consent—and many centers use them in their marketing strategies.

However, Ventrell notes that some popular television talk shows are known to follow individuals in crisis and might ask a treatment center to cooperate with the show producers. NAATP members must avoid any situation that would exploit a patient for what is essentially entertainment, however, upholding ethics as they relate to media interaction might be evaluated on a case-by-case basis, he says. And clearly, the show shouldn’t have any financial ties to the treatment center.

“There’s nothing wrong with Dr. Phil or anyone referring someone to a center for assessment and treatment as long as there’s no payment for that referral,” he says.

Improved status

NAATP is planning to offer in-person and online training sessions for members, according to Tieman. In time, the association also will compile a list of providers that have completed training and pledge to follow the ethics code. That list could be valuable to third-party payers looking to contract with the best quality providers.

“You’ve got a built-in advantage because you can say you’re doing things the right way,” Tieman says.

In his experience, payers are skeptical of most providers because they all claim to be high quality but have no way to verify it. Tieman anticipates that NAATP membership could serve as that verification and ultimately offer a competitive advantage in the market.