MIAMI, Fla. — A 48-year-old Delray Beach doctor was sentenced Monday to 20 years in prison for engaging in a multi-year fraud involving sober homes in the largest addiction fraud treatment case ever charged by the Department of Justice.
Michael J. Ligotti was the medical director or authorizing physician for more 50 sober homes, substance abuse treatment facilities and clinical testing laboratories in the Palm Beach County area. Court papers show he billed insurance companies more than $746 million and paid himself approximately $127 million for fraudulent urine drug tests and addiction treatments.
This case was brought as part of the Department of Justice’s Sober Homes Initiative.
“For nearly a decade, Michael Ligotti exploited vulnerable patients seeking addiction treatment, a reprehensible abuse of trust by a physician,” Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division, said in a news release. “This defendant will now serve many years in federal prison for using his medical license to authorize fraudulent tests and treatments for addicted patients at treatment centers and sober homes throughout South Florida.'
On Oct. 4, Ligotti accepted a plea agreement of conspiracy to commit health care and wire fraud. It was multi-year scheme to bill health care benefit programs for fraudulent tests and treatments for vulnerable patients seeking treatment for drug and/or alcohol addiction.
In Miami, Southern District of Florida Judge Rodolfo A. Ruiz, II also ordered restitution to be determined and to surrender his medical license.
From 2011 to 2020, prosecutors said Ligotti billed patients’ private health insurance plans for "duplicative, medically unnecessary, and expensive urine drug tests, blood tests and other addiction treatments."
In the scheme, facilities routinely sent patients’ urine specimens to clinical testing laboratories and health care benefit programs were for unnecessary urine drug tests, including some costing thousands of dollars for a single test.
The treatment centers required patients to regularly visit Ligotti’s clinic, Whole Health LLC, for additional treatment and testing, or his staff to come to their treatment facilities to conduct tests and treatment there.
"The victims are real, and the losses are immense,” Acting Special Agent in Charge Chad Yarbrough of the FBI Miami Field Office said. “Instead of ensuring the proper treatment of the vulnerable patients under his care in over 50 sober homes, Michael J. Ligotti gamed the system for millions of dollars in ill-gotten gains.
"The investigators who unraveled this scam are to be commended for their diligence and commitment. The FBI and our partners will continue to pursue those individuals who use our health care system to prey on the vulnerable and steal from the taxpayers.”
Investigating the cases were the FBI Miami Division Palm Beach Resident Agency, Drug Enforcement Administration West Palm Beach Diversion Group; IRS Criminal Investigation Miami Field Office; Amtrak Office of Inspector General; Department of Labor Employee Retirement Income Security Act; Florida Department of Financial Services, Division of Investigative and Forensic Services; and Palm Beach County Office of the State Attorney investigated the case.
The DOJ's Sober Homes Initiative was initiated in September 2020 to prosecute defendants who exploit vulnerable patients seeking treatment for drug and/or alcohol addiction. The initiative has resulted in charges and guilty pleas or convictions involving 28 criminal defendants in two judicial districts in connection with over $1 billion in alleged false billings.
Ligotti received a Bachelor of Arts degree from Florida Atlantic and a medical degree from Nova-Southeastern College of Osteopathic Medicine.