Florida Doctor Charged in $681 Million Treatment Fraud Scheme

A doctor in Palm Beach County, Florida, has been charged with conspiring to commit healthcare fraud and wire fraud for allegedly participating in a years-long scheme of billing for fraudulent tests and treatment for patients seeking care for drug and/or alcohol addiction, the U.S. Justice Department announced.

Michael J. Ligotti, DO, was charged with conspiracy to commit healthcare fraud and wire fraud. Ligotti is accused of fraudulently billing private insurers and Medicaid for about $681 million for lab testing claims and other services, for which they paid $121 million. The alleged actions took place between May 2011 and March 2020.

Ligotti was the owner and operator of Whole Health, a private clinic that offered addiction treatment, family care and urgent care in Delray Beach, Florida. According to a Justice Department news release, Ligotti is suspected of:

• Agreeing to become “the purported ‘medical director’ ” for addiction treatment facilities and sober homes for a nominal fee
• Authorizing standing orders for hundreds of millions of dollars in medically unnecessary urine screenings, which were billed by testing labs that sometimes paid kickbacks to sober homes and treatment cents
• Requiring facilities to have patients treated by Whole Health, allowing him to bill for more fraudulent treatments and tests

Ligotti is also accused of billing for psychiatric services that never happened and improperly prescribing large quantities of controlled substances. The Justice Department further alleges that the urine screenings were not actually used in patient treatment, but only as a revenue generator.

Ligotti allegedly worked as the medical director for more than 50 treatment centers and signed more than 136 standing orders, the Justice Department said.