Dr. Michael Ligotti is facing serious charges after the federal government said that he was implicated in a scheme that defrauded insurance companies out of over half a billion dollars. According to investigators, Ligotti is said to have bilked insurance companies of $681 million.
Ligotti was originally investigated in connection with an addiction treatment center. Now, the feds say that Ligotti was involved in other such schemes with other addiction treatment centers.
Ligotti is facing charges for conspiracy to commit wire fraud and wire fraud. The alleged fraud went on for nine years before anyone caught on. Authorities say that Ligotti charged insurance companies for procedures that were never conducted and tests that were never given. They say he preyed on vulnerable patients seeking treatment for drug and alcohol problems.
The U.S. Department of Justice announced the new charges in late July.
Ligotti Enters an Innocent Plea
Through an attorney, Ligotti said that the U.S. Department of Justice’s allegations were one-sided claims that they have very little evidence for and that Dr. Ligotti is looking forward to proving his innocence.
Ligotti, who is a licensed osteopathic physician, opened up a general care facility in 2005. The clinic offered family care, urgent care, and addiction care.
According to the U.S. Department of Justice, Ligotti ordered millions of dollars in useless urine testing on patients who carried insurance. The facility would bill the insurance company, and the insured wouldn’t know that they’d been billed or that the urine tests were useless. In some cases, the testing labs paid kickbacks to the facilities that were ordering the tests. The feds say that the scheme bloomed into hundreds of millions of dollars worth of unnecessary tests. They say some patients were billed nearly $20,000 for a single visit.
Eventually, there were over 50 addiction treatment clinics that had signed onto the scheme. These facilities relied on Ligotti’s signature to order the tests. All of the tests went through a single laboratory, Whole Health.
Further, Ligotti is accused of improperly prescribing drugs, including opiates, to patients under his care. He also treated more patients than is allowed by law.
At least some of the costs were absorbed by taxpayer-funded programs like Medicare and Medicaid. Insurance companies paid out $121 million of the $681 million charged by Ligotti’s practice.
Unfortunately, the urine of addicts is a major cash cow for testing companies. Ligotti essentially cornered the market by brokering these kickback deals. However, the main contention of the state’s argument is that the tests were unnecessary, never given, or otherwise constituted fraud against insurers.
Talk to a West Palm Beach Criminal Defense Attorney
If you’ve been charged with a serious crime, you need a West Palm Beach criminal attorney who will force the state to prove every element of their case against you. Call The Skier Law Firm, P.A. today to learn more about how we can help.