Florida Doctor Sentenced for Substance Abuse Treatment Fraud Scheme | OPA

A Florida doctor was sentenced today to twenty years in jail for appealing in a huge multi-year scheme to expense health care advantage programs for deceptive tests and treatments for susceptible patients looking for treatment for drug and/or alcohol addiction This case was brought as part of the Department of Justice’s Sober Residences Effort.

” For almost a years, Michael Ligotti made use of susceptible patients looking for addiction treatment, a guilty abuse of trust by a doctor,” stated Assistant Attorney general of the United States Kenneth A. Polite, Jr. of the Justice Department’s Lawbreaker Department. “This offender will now serve several years in federal jail for utilizing his medical license to license deceptive tests and treatments for addicted patients at treatment centers and sober houses throughout SouthFlorida This marks the biggest addiction fraud treatment case ever charged by the Department of Justice, showing our continuing dedication to dealing with health care fraud throughout the nation.”

According to court files, Michael J. Ligotti, D.O., 48, of Delray Beach, acted as Medical Director or Licensing Doctor for over 50 sober houses, substance abuse treatment centers, and clinical screening labs in the Palm Beach County location, typically signing standing orders for costly, medically unneeded urine drug tests for patients at different addiction treatment centers. These centers consistently sent out patients’ urine specimens to clinical screening labs, which then billed health care advantage programs for unneeded urine drug tests, typically thousands of dollars for a single test. In exchange for Ligotti’s permission of these urine drug tests, the treatment centers needed their patients to frequently go to Ligotti’s center, Entire Health LLC, for extra treatment and screening, or permitted Ligotti’s staff to come to their centers to conduct tests and treatment there. This permitted Ligotti to earnings by billing patients’ personal health insurance plans for duplicative, medically unneeded, and costly urine drug tests, blood tests, and otheraddiction treatments As an outcome of this conduct, which happened from 2011 to 2020, health care advantage programs were billed over $746 million and paid around $127 million for deceptive urine drug testsand addiction treatments Ligotti pleaded guilty to conspiracy to devote health care and wire fraud in the Southern District of Florida in October 2022 and was purchased today to surrender his medical license.

” The victims are genuine, and the losses are tremendous,” stated Performing Unique Representative in Charge Chad Yarbrough of the FBI Miami Field Workplace. “Rather of making sure the appropriate treatment of the susceptible patients under his care in over 50 sober houses, Michael J. Ligotti gamed the system for millions of dollars in ill-gotten gains. The private investigators who deciphered this rip-off are to be applauded for their diligence and dedication. The FBI and our partners will continue to pursue those people who use our health care system to victim on the susceptible and take from the taxpayers.”

” The outcomes in this case strengthen our dedication and decision to pursue those who would defraud Amtrak’s health care programs and target susceptible populations,” stated Unique Representative in Charge Mike Waters of the Amtrak Workplace of Inspector General’s Eastern Field Workplace. “Our representatives will continue to work carefully with the job force and partner firms to hold criminals responsible and secure Amtrak’s resources, its staff members, and their dependents.”

The FBI Miami Department Palm Beach Citizen Firm, with assistance from DEA West Palm Beach Diversion Group; Internal Revenue Service Crook Examination Miami Field Workplace; Amtrak Workplace of Inspector General; Department of Labor Worker Benefits Security Administration; Florida Department of Financial Providers, Department of Investigative and Forensic Providers; and Palm Beach County Workplace of the State Lawyer examined the case.

Senior Lawsuits Counsel James V. Hayes and Trial Lawyer Ligia M. Markman of the Lawbreaker Department’s Fraud Area and Assistant U.S. Lawyer Alexandra Chase, Chief, Transnational, Trafficking & & Cyber Crimes System for the Southern District of Florida prosecuted the case.

The National Rapid Reaction Strike Force, Los Angeles Strike Force, and Miami Strike Force of the Crook Department, Fraud Area, and the U.S. Lawyers’ Workplaces for the Southern District of Florida and Central District of California lead the Department of Justice’s Sober Residences Effort, which was started in September 2020 to prosecute offenders who make use of susceptible patients looking for treatment for drug and/or alcohol addiction Considering that its creation, the Sober Residences Effort has actually resulted in charges and guilty pleas or convictions including 28 criminal offenders in 2 judicial districts in connection with over $1 billion in declared incorrect billings for deceptive tests and treatments for susceptible patients looking for treatment for drug and/or alcohol addiction

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