A South Florida doctor who made millions in health care pleads guilty to fraud conspiracy [South Florida Sun-Sentinel]

South Florida Sun Sentinel (FL)

A Delray Beach doctor has pleaded guilty on a federal charge of conspiracy to commit health care fraud after prosecutors said he billed for fraudulent tests and treatments for vulnerable patients who were seeking treatment for drug or alcohol addiction, or both.

The complaint against Dr. Michael Ligotti claims that for almost 10 years, from May 2011 until March 2020, he was billing private insurance companies and Medicare for laboratory testing and other services that were “excessive and medically unnecessary,” or psychiatric services and therapy sessions that never happened.

Authorities said he billed the companies about $681 million worth of services. They paid out about $121 million.

Authorities alleged Ligotti “entered into quid pro quo agreements” with others “to provide ‘standing orders’ for medically unnecessary tests at sober homes and addiction treatment facilities as their purported Medical Director, and in return these treatment facilities brought their patients” to his primary care and addiction treatment clinic, Whole Health.

One “cooperating defendant,” who received a 10-year prison sentence, admitted that their sober home and addiction treatment center would offer patients free room and board and airline tickets to entice patients to come, and said they and Ligotti had a “wink-wink” relationship.

As part of the relationship, Ligotti would sign a standing order for the cooperating defendant, and in return that person “would send his/her patients to Ligotti’s office, where Ligotti would bill their insurance for additional testing and services,” according to the complaint.

On Tuesday, Ligotti pleaded guilty to one count of the indictment, which charged him with conspiracy to commit health care and wire fraud, according to a spokeswoman for the U.S. Attorney’s Office.

Ligotti’s sentencing is set for 1 p.m. Dec. 13. The maximum penalty is 20 years in prison and a fine, according to the criminal complaint.

Broward and Palm Beach counties have become “destinations for drug and alcohol addicts seeking assistance in becoming and remaining sober,” according to the criminal complaint. Treatment for substance abuse is Palm Beach County’s fourth largest industry.

Lisa J. Huriash can be reached at [email protected]. Follow on Twitter @LisaHuriash