Here, in the state of Florida, we have been dealing with quite a lot lately. The coronavirus pandemic has hit us all pretty hard. On behalf of the entire Allegiant Experts team, we’d like to send out our best wishes to everyone. Please stay safe and do your part to help stop the spread of COVID-19. Unfortunately, some Floridians seem to have other things on their minds when it comes to our health.
Enter 46 year-old Michael J. Ligotti.
The Palm Beach County doctor was just charged with conspiracy to commit health care fraud and wire fraud. As reported by the United States Department of Justice last week, Ligotti has been arrested after years of participating in a health care fraud scheme.
Among his illegal actions were billing for fraudulent tests and treatments for vulnerable patients who were seeking treatment for drug and/or alcohol addiction. According to the DoJ report, Ligotti carried out his fraudulent activities between May of 2011 and March of this year. During that time, he sent bogus claims to Medicare and other private insurance companies totalling upwards of $681 million.
Fraudulent laboratory testing was among Ligotti’s claims.
He also claimed for other services as part of this fraudulent scheme, for which approximately $121 million was paid out. Ligotti took advantage of his ownership of Whole Health in Delray Beach, Florida to pull off his scheme.
The private clinic, details the DoJ, offered addiction treatment, family care and urgent care among other services. While operating Whole Health, Ligotti agreed to become the purported “Medical Director” for an addiction treatment facility or sober home for a nominal fee.
He also authorized “standing orders” for hundreds of millions of dollars in medically unnecessary urinalysis tests (UAs). They were then billed by testing laboratories that would sometimes pay kickbacks to the sober homes or addiction treatment facilities. Finally, in exchange for Ligotti’s signature on these standing orders, he required the facilities to have their patients treated by Whole Health and his staff.
Ligotti billed hundreds of millions of dollars in additional fraudulent treatments.
Such treatments included unnecessary and expensive UAs, costly blood tests, non-existent therapy sessions, office visits and other unnecessary services. It didn’t matter whether any of the treatments or testing was actually medically necessary and/or actually provided.
The DoJ also reports that “Ligotti allegedly did not meaningfully review the results of the tests he ordered or use the results of the tests to treat these patients, either at his clinic or at the addiction treatment facilities.” They also note that Ligotti allegedly served as “Medical Director” for more than 50 addiction treatment facilities and signed over 136 standing orders authorizing such fraudulent tests.
Are you an attorney who is currently trying a health care fraud case?
Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Our experts have been providing expert clinical services for nearly two decades and can help your team by bridging the disciplines of medicine, coding and billing to ensure accurate payment and data is achieved. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.