A 46-year old doctor based in Palm Beach County, Florida, was arrested for allegedly conspiring with others to exploit addiction treatment in a healthcare scheme that involved billing insurance companies hundreds of millions of dollars for fraudulent tests and treatments.
According to a U.S. Department of Justice press release dated July 29, Dr. Michael J. Ligotti was charged with conspiracy to commit healthcare fraud and wire fraud. The complaint alleges that Ligotti ran a Delray Beach-based private health center known as Whole Health that offered services such as family care, urgent care, and addiction treatment. He is alleged to have fraudulently billed private insurance companies and Medicare approximately $681 million for laboratory testing claims and other services from May 2011 to March 2020. The companies paid out about $121 million.
The release added that Ligotti ran over 50 other treatment facilities aside Whole Health over the scheme's course. He is believed to have asked patients from these treatment facilities to submit testing and treatments he authorized at Whole Health. This enabled him to bill these patients’ insurance companies for fraudulent tests and treatments. Ligotti was also accused of ordering and conducting bogus blood tests, and Urinalysis (UA) tests that were never used in treating his patients.
“The substance abuse treatment fraud allegedly perpetrated by the defendant sacrificed the genuine care of vulnerable patients at a time when they urgently needed a trusted health care provider,” said U.S. Attorney Ariana Fajardo Orshan. “Health care providers who allow greed to take precedence over their Hippocratic Oath and participate in these schemes are criminals and will be held accountable for their unscrupulous conduct.”
Apart from the fraudulent, Ligotti allegedly billed his patients’ insurance companies for therapy sessions and psychiatric services that never took place. Some patients were alleged to have been billed as much as $20,000 for a single day’s visit. The release added that Ligotti allegedly prescribed large amounts of buprenorphine/suboxone, a narcotic primarily used to fight opioid addiction to patients who did not need it.
The case was investigated by the FBI's Palm Beach County RA in collaboration with the IRS-Criminal Investigation Florida Division of Investigative and Forensic Service, Amtrak Office of Inspector General, the Drug Enforcement Addition and the Palm Beach County State County State Attorney's Office.
If you have any information regarding that could be useful in prosecuting the case, kindly email ReportML@FBI.GOV using the title “Ligotti Whole Health.”