Delray Beach Doctor Who Supervised Drug Testing For Dozens Of Addiction Treatment Practices Gets Prison Sentence For Healthcare Fraud
Plenty of newsworthy stories about COVID relief fraud have come out of Florida, but it doesn’t take a pandemic to make Floridians look at widespread ill health and see dollar signs. Healthcare is big business everywhere in the United States, but this is especially the case in Florida, where you can hardly take ten steps in any direction without encountering a Medicare-eligible patient, where cosmetic surgery is so prevalent that siblings bear little resemblance to each other, and where addiction rehab clinics and sober homes have sprung up where the notorious pill mills once stood. This month, a Palm Beach County physician received a prison sentence after pleading guilty to charges stemming from a years-long healthcare fraud operation that ended just before the first cases of COVID-19 in Florida were diagnosed. If you are being accused of healthcare fraud, contact a West Palm Beach white collar crime lawyer.
Defendant Billed Patients’ Insurance Companies for Duplicate or Unnecessary Tests
Sober homes are group homes for people who have recently completed inpatient treatment for substance use disorder; therefore, there is no physician present on the premises of any given sober home most of the time. Despite this, only licensed physicians can order the blood tests or urine tests required to ensure that residents are continuing to abstain from drugs. Therefore, every sober home has a medical director supervised to order and review drug tests and other medical needs at the facility.
Michael Ligotti was employed as a medical director of approximately 50 sober living homes in southern Florida. Between 2011 and 2020, he filed approximately $746 million in fraudulent insurance claims for drug tests for the patients in the sober homes he supervised. He offered the employees of the sober homes financial incentives to request drug tests for their residents, even if the resident had already done the same test on the same day in a different location. He also prescribed buprenorphine, a drug used to treat opioid use disorder, to many patients who did not need it. He received about $127 in income from the scheme.
The trouble began when 12 patients who had been prescribed medication by Ligotti died, leading to an investigation into potential medical malpractice. In 2020, investigators uncovered the fraud, even as Ligotti tried to get rid of assets he had purchased with the proceeds of the fraudulent claims. The strongest evidence against Ligotti came when the director of one of the sober homes, who also faced criminal charges and received a prison sentence, testified as to Ligotti’s role in the scheme. In October 2022, Ligotti surrendered his medical license as he pleaded guilty to conspiracy to commit healthcare fraud. In January 2023, he was sentenced to 20 years in prison.
Contact a West Palm Beach White Collar Crimes Lawyer Today
Attorney William Wallshein has more than 38 years of experience, including five years as a prosecutor in Palm Beach County. Contact William Wallshein P.A. in West Palm Beach, Florida to discuss your case.