A Medical Doctor Engineered an Illegal Substance Abuse Treatment Fraud Scheme

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Jail time will be keeping a doctor away for good. Michael Ligotti, a medical doctor from Florida, was sentenced to federal prison for 20 years to face the consequences of a healthcare fraud scheme. Ligotti turned out to be a treacherous engineer of an illegal scheme that billed healthcare programs for fraudulent tests and treatments aimed at drug and alcohol addiction patients. Instead of advocating for the well-being of his patients, Ligotti betrayed his patients’ trust by orchestrating the illegal scheme that took place for almost a decade.

Michael Ligotti, 48, worked as a Medical Director or the authorizing physician for 50 sober homes, substance abuse treatment facilities, and clinical testing laboratories in Palm Beach County. Prosecutors revealed that he conspired with several sober homes that he worked for. This is where the scheme unravels as Ligotti authorizes standing orders for expensive, medically unnecessary urine drug tests for patients at addiction treatment facilities. So, the facilities involved would charge healthcare benefit programs for unnecessary urine drug tests that nearly cost thousands of dollars. Additionally, Ligotti benefits from this when the facilities require the patients to visit Ligotti’s clinic on a regular basis to undergo additional testing and treatment. In some cases, the facilities would allow Ligotti’s staff to visit the facilities. From 2011 to 2020, Ligotti would illegally profit from this scheme by submitting bills to the patients’ private health insurance plans for expensive and unnecessary urine drug tests, blood tests, and other addiction treatments. The billed statements amounted to more than $746 million and the healthcare program paid approximately $127 million.

A person who managed one of the sober homes confirmed the healthcare fraud conspiracy and the court sentenced the individual to ten years in federal prison. Ligotti’s role in the scheme was confirmed by former employees and patients who testified that he insisted on excessive blood and urine testing without necessary medical benefits. What makes this worse is that Ligotti prescribed potentially harmful opioids and exceeded the limit of what was allowed. Whole Health Clinic, owned by Ligotti, did not review or evaluate the drug test results. According to the complaint, this makes prescribing buprenorphine “a dangerous practice, especially given the potentially deadly combination of mixing buprenorphine with benzodiazepines.” A healthcare fraud twisted into an extremely destructive tale as it was found out that twelve people who had active prescriptions from Ligotti died and a warrant for their medical records would search for their cause of death.

On October 2022, Michael Ligotti pleaded guilty to conspiracy to commit healthcare and wire fraud in the Southern District of Florida. Consequentially, he was ordered to surrender his medical license on January 9, 2023. The medical providers involved in the scheme clearly exploited the vulnerability of their patients and cheated the system. They were misled by their sinister intentions in favor of obtaining ill-gotten gains even if it meant performing dangerous practices that harmed the patients. Their fraudulent activities in the clinic culminated in a guilty verdict and a prison sentence ruled by the court.

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