The federal authorities has charged a Florida behavior medicine specialist in what it says was a scheme to defraud Medicare and private insurers, charging them roughly $681 million over a couple of decade for lab exams, office visits, treatment courses, and completely different suppliers which have been each pointless or in no way delivered.
The US Division of Justice (DOJ) and the US Lawyer for the Southern District of Florida are prosecuting Michael Ligotti, DO, 46, saying that he preyed on folks in the hunt for substance abuse treatment. They’ve however to concern a correct indictment.
“The substance abuse treatment fraud allegedly perpetrated by the defendant sacrificed the true care of prone victims at a time after they urgently wished a trusted effectively being care provider,” US Lawyer Ariana Fajardo Orshan, Southern District of Florida, acknowledged in an announcement.
“Nicely being care suppliers who allow greed to take precedence over their Hippocratic Oath and participate in these schemes are criminals and shall be held accountable for his or her unscrupulous conduct,” she added.
Ligotti was charged July 31. The prosecutors have been in the hunt for to detain him until trial. Nonetheless, a resolve accredited his bond proper this second and he is free on bond, in response to Ligotti’s authorized skilled, Ben Curtis.
“As is always the case with any jail matter, the burden of proof rests utterly with the federal authorities,” Curtis knowledgeable Medscape Medical Data.
“On this event, we do not think about the US Division of Justice’s claims —and that is exactly what they’re at this stage, merely one-sided claims — will reconcile with exact proof at a future trial,” he acknowledged.
Curtis added that Ligotti “appears to be forward to establishing his innocence.”
Pointless Urine Exams
The federal authorities alleges that Ligotti carried out a central perform in a scheme whereby Medicare and private insurers paid about $121 million to cowl some $680 million in costs from 2011 to 2020.
Primarily based on the prosecutors, Ligotti acquired a fee for becoming a “purported” medical director of about 50 behavior treatment companies and sober homes — and that he issued 136 separate standing orders for medically pointless urinalysis (UA) exams.
The labs allegedly paid occasional kickbacks to the companies and homes, and folks companies in flip have been required to have their victims dealt with by Ligotti’s clinic, Full Nicely being, which depends in Delray Seashore, Florida.
This allowed Ligotti to “bill a complete bunch of lots of of hundreds of in further fraudulent treatments, along with pointless and expensive UAs, costly blood exams, nonexistent treatment courses, office visits, and completely different pointless suppliers, regardless of whether or not or not such treatment and testing have been medically wanted and/or really provided,” alleges the federal authorities.
Ligotti did not overview outcomes or use the outcomes to inform affected particular person treatment, in response to the DOJ.
Urine exams have been exploited sooner than by behavior treatment clinics as a earnings generator. Kaiser Nicely being Data reported in 2017 single nurse practitioner at one ache clinic in Tennessee generated $1 million in billings to Medicare for drug-related urine exams in a single yr.
Moreover in 2017, The New York Cases reported single affected particular person had been billed $260,000 for urine exams by his treatment coronary heart.
The federal authorities alleges that Ligotti moreover “billed for psychiatric suppliers and treatment courses that in no way occurred, and that he and his workers weren’t licensed to conduct.”
In addition to, they assert that Ligotti improperly prescribed managed substances, along with big parts of buprenorphine/Suboxone, often exceeding the number of victims he was legally licensed to take care of or giving it to victims who did not require the medicines.
Ligotti won’t be practising any longer. His clinic’s website online encompasses a message that the apply shall be closed as of this Friday.
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