A Montana addiction clinic wants to motivate people with rewards. Then came a Medicaid fraud probe


A Montana addiction clinic’s plan to give people with substance use disorders as much as $1,966 in gift cards and vouchers to follow its treatment program is raising questions about the use of financial incentives with patients.

The tug of war over the effective but largely unregulated tool is playing out in the northwestern Montana town of Kalispell, where a local government grant is financing rewards for people who stick with treatment provided by the outpatient clinic Oxytocin.

Such incentives have gained momentum among individual health clinics and states in recent years. Since 2021, California, Washington, and Wisconsin have started incentive-based programs. Some private clinics offer their own rewards, such as giving clients gift cards for successfully passing a drug test.

In Montana, where Republican Gov. Greg Gianforte has made expanding behavioral health care a priority, a state pilot program offers prizes to people with addictions who stay off drugs. Oxytocin’s program, while funded by a government grant, is separate from the pilot program.

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The allowable value of prizes that go to beneficiaries of federal health programs, like Medicaid, is a legal gray area,

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