Howdy, Review Fraud
CodeMax Medical Billing handles medical billing and claims for addiction recovery businesses. According to the lawsuit filed on August 28, 2026, CodeMax allegedly played fast and loose with its billing practices. CodeMax is one of 74 businesses named in the lawsuit. All of the named businesses are located in California. CodeMax recieved a portion of the claim.
The lawsuit alleges a three-part scam.
1. Manufacture the patients.
2. Manufacture the claims.
3. Maximize the illicit profits.
The lawsuit alleges that people received treatment one day after enrolling in BCBS. These people were enrolled in insurance in Oklahoma and then received treatment the next day in California. One example claimed a person was enrolled on March 1st, 2024, and the next day received treatment at New Life. This patient was billed from March 2, 2026, through April 1, 2026. They again recieved treatment from August 6, 2024, through August 30, 2024.
In another example, a person was enrolled in BCBS on March 1st. The next day, this person was receiving treatment at Freedom Recovery. Their treatment took place through March 22, 2024. On August 9, 2024, the patient received treatment at Connected Recovery in Van Nuys. The patient stayed until August 15, 2024. LH Blue Sky billed the patient from May 1, 2026, through June 1st; from June 5, 2024, through June 25; and finally from August 10 and 11. Sun and Moon billed a patient from May 1 through June 1st. HigherVision then billed this patient from August 18 through September 4, 2026. These patients provided burner or temporary email addresses.
Several facilities started billing for services within seven days of enrollment.
Freedom Recovery: 15 patients
Connected Recovery: 14 patients
Uplift Recovery: 10 patients
Vanity Wellness: nine patients
California Wellness: eight patients
LH Blue Sky: eight patients
Sadag: seven patients
Pure: seven patients
Granada Hills: seven patients
Vanity Detox: seven patients
Wish: six patients
Inspire Recovery: five patients
Ritz: five patients
Journey: five patients
Vita Nova: five patients
The manufacturing claims portion appears to be multilayered. BCBS alleges that defendants created claims based on pretense, identifying treatments that were not (or could have been) performed, and listing fake charges. CodeMax created claims for providers with inflated and fake charges. CodeMax submitted claims for the patient under different providers. CodeMax billed Patient A on August 14, 2024, at Vita Nova and Soul Detox. CodeMax billed Patient B on August 16, 2024, at California Wellness and Sun and Moon. A claim was filed for Patient C at Sun and Moon and California Wellness on August 17, 2024. Another patient had claims submitted on August 17 at Ritz Recovery and Granada Hills. California Wellness and Sun and Moon submitted claims for the same patient on August 18. New Breath and 4 Seasons also filed claims for the same patient on September 4, 2024.
Facilities also billed for more patients than they were allowed to treat. Granada Hills is allowed to house up to six patients at a time. It’s alleged that they exceeded that limit on multiple days between August and September. Ananda and Sun and Moon also had more patients than they were allotted. On several days, more than two-thirds of the patients were from BCBS of Oklahoma.
4 Season: 189 d days
Sun and Moon: 160 days
Freedom Recovery: 137 days
Connected Recovery: 128 days
Casa Leona: 123 days
New Breath: 114 days
360 Recovery: 110 days
Rise In Glendale: 105 days
Saint Lawrence: 105 days
Granada Hills: 97 days
Journey: 95 days
Soul Detox: 91 days
Ansuva: 91 days
EHG: 87 days
Believe Detox: 68 days
Ananda: 67 days
Aya: 65 days
HigherVision: 64 days
Clear Conscience: 60 days
Willpower Recovery: 54 days
Integrity Recovery: 53 days
Glendale Luxury: 53 days
Vanity Detox: 50 days
BCBS questions whether these patients existed. Either the patients never existed, or the facilities were over capacity.
The final component in the lawsuit alleges the maximization of illicit profits. CodeMax submitted electronic claims between 2023 and 2024. In August 2024, CodeMax advertised that it had found a way to skirt the algorithm. CodeMax started mailing claims. BCBC claims that CodeMax tested this system by mailing claims and repeatedly checking the claim status. The claim was 10 times the amount it should have been.
While CodeMax tested this new method, they drastically reduced the number of electronic claims. Once the new method worked, they quickly mailed in the backlog of claims. About a dozen test claims were submitted for Inspire Recovert, Vanity Wellness, or Vanity Detox.
August 28, 2024: 368 claims totaling $2,586.901
August 29, 2024: 570 claims totaling $4,061,489
August 30, 2024: 9 claims totaling $59,585
September 3, 2024: 1 claim for $8,084
September 4, 2024: 563 claims totaling $3,808,757
September 5, 2024: 943 claims totaling $6,234,851
September 6, 2024: 1 claim for $8,084
September 9, 2024: 81 claims totaling $476,524
September 11, 2024: 434 claims totaling $2,779.126
September 12, 2024: 56 claims totaling $363,423
September 13, 2024: 9 claims totaling $46,501
LA Wellness, Wish Recovery, Inspire Recovery, Vanity Detox, Geva Recovery, Willpower Recovery, Lakeridge, Uplift Recovery, Integrity Recovery, Deluxe Treatment, and West Valley all submitted claims for codes 0126 and 1002 for more then should have been submitted.
Here is the full list of facilities named in the lawsuit:
28’s REHAB
360 INTEGRATED RECOVERY INC
4 HEALTHY LIVING DETOX, INC
4 SEASON DETOX AND RECOVERY HOUSE INC
A1 TREATMENT CENTER
ALPHA RECOVERY CENTER, INC
ALTITUDE RECOVERY COMMUNITY LLC
ALTITUDE RECOVERY COMMUNITY NO. 2 LLC
ALTUS KEHAB LLC
AME HEALTHCARE GROUP LLC d/b/a VITA NOVA AT NEWPORT BAY
AMERICAN RECOVERY CENTER
ANANDA, INC. d/b/a ANANDA TREATMENT BEHAVIORAL HEALTH AND WELLNESS CENTER
ANSUVA INC
AYA REHAB CENTER LLC
BELIEVE DETOX CENTER INC
CA DRUG DETOX LLC
CALIFORNIA WELLNESS RETREAT, INC
CASA LEONA RECOVERY CENTER INC
CELEBRATED CONSULTING INC
CHC BEHAVIORAL HEALTH LLC
CLEAR CONSCIENCE TREATMENT CENTER LLC
COMFORT RECOVERY TREATMENT CENTER LLC
CONNECTED RECOVERY INC
DELUXE TREATMENT CENTER INC
EAGLE RECOVERY
EHG ENTERPRISES INC
ENCINO RECOVERY INC
ESSENCE HEALTH CARE LLC
FREEDOM DRUG AND ALCOHOL RECOVERY INC
GARRET RECOVERY CENTER
GEVS RECOVERY CENTER
GLENDALE LUXURY REHAB LLC
GRANADA HILLS TREATMENT CENTER LLC
HIGHERVISION GH INC
HOPE DETOX CENTER LLC
INSPIRE RECOVERY CENTER INC
INTEGRITY RECOVERY CENTER
JOURNEY OF A NEW LIVING
LA WELLNESS HOME INC
LAKERIDGE RECOVERY CENTER
LANDALE RECOVERY CENTER
LH BLUE SKY, INC
LION RECOVERY
LNA REALTY
MEDICHEX, INC. d/b/a LIFT OFF RECOVERY
NEW BREATH RECOVERY INC
NEW LIFE RECOVERY CENTER
NEW LIFE, INC
OASIS DETOX INC
OASIS REHABILITATION CENTER INC
PURE ADDICTION TREATMENT
REGGIE’S RECOVERY, LLC
RESILIENT RECOVERY TREATMENT CENTER
RISE IN GLENDALE SOBRIETY CENTER, INC
RISING LOTUS RECOVERY LLC
RITZ RECOVERY INC
SADAG TREATMENT SOLUTIONS, LLC
SAINT ANGEL RECOVERY CENTER, INC
SAINT LAWRENCE RECOVERY
SEOUOIA RECOVERY CENTER
SHADOW HILLS RECOVERY INC
SOUL DETOX AND RECOVERY INC
STAR CITY RECOVERY INC
SUN AND MOON REHABILITATION
TARZANA RECOVERY CENTER
TRANQUILITY RECOVERY CENTER, INC
TRINITY HEALTH ARTNERS LLC
UPLIFT RECOVERY CENTER LLC
VANITY DETOX CENTER INC
VANITY WELLNESS CENTER INCORPORATED
WILLPOWER RECOVERY CENTER, INC
WISH RECOVERY HOUSE LLC
The following facilities were named in the now dismissed lawsuit brought by BlueCross Blue Shield of Florida:
CA DRUG DETOX LLC
CLEAR CONSCIENCE TREATMENT CENTER LLC
COMFORT RECOVERY TREATMENT CENTER LLC
DELUXE TREATMENT CENTER INC
EHG ENTERPRISES INC
INSPIRE RECOVERY CENTER INC
LAKERIDGE RECOVERY CENTER
LNA REALTY
MEDICHEX, INC. d/b/a LIFT OFF RECOVERY
NEW BREATH RECOVERY INC
NEW LIFE, INC
SAINT LAWRENCE RECOVERY
SUN AND MOON REHABILITATION
UPLIFT RECOVERY CENTER LLC
VANITY DETOX CENTER INC
VANITY WELLNESS CENTER INCORPORATED
Hopefully, BCBS of Florida will refill the lawsuit.
