South Florida doctor sentenced to prison for fraud related to unnecessary drug addiction tests, treatment

South Florida Sun Sentinel (FL)

A Delray Beach doctor who served at over 50 substance abuse treatment facilities and laboratories across South Florida was sentenced to 20 years in federal prison on Monday for conspiracy to commit healthcare fraud.

Michael Ligotti, 48, pleaded guilty in October to participating in a scheme that spanned nearly a decade and billed private insurance companies nearly $750 million for “excessive and medically unnecessary” drug tests and other addiction treatments, including psychiatric services and therapy sessions that never happened.

According to the U.S. Attorney’s Office, Ligotti became either a medical director or authorizing physician at substance abuse treatment centers, sober homes, and testing laboratories and entered into “quid pro quo agreements” with them in order to obtain patients for his own clinic, Whole Health in Delray Beach.

He would provide standing orders for blood and urine drug tests at these treatment centers, and the treatment centers would submit insurance claims for reimbursement.

In exchange, Ligotti required the treatment centers to send their patients to Whole Health for “purported substance abuse treatment,” and to allow Whole Health staff to treat patients at their own facilities. Whole Health would then order more “excessive and medically unnecessary” drug tests for these patients, the U.S. Attorney’s Office said.

One “cooperating defendant” who had such an agreement with Ligotti admitted that their sober home and treatment center offered free room and board and airline tickets to entice patients.

“This massive, multi-year alleged fraudulent billing scheme by a trusted medical professional generated millions of dollars by preying on patients seeking substance abuse treatment,” Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division said at the time of the arrest in 2020.

The investigation focused on events that occurred from May 2011 until March 2020. He was arrested on July 29, 2020.

Ligotti pleaded guilty in October 2022 to one count of the indictment, which charged him with conspiracy to commit health care and wire fraud. He has been ordered to surrender his medical licenses.