Michael J. Ligotti, arrested for alleged involvement in $681M scheme

A Delray Beach doctor was arrested for allegedly exploiting addiction treatment in a healthcare scheme that billed insurance companies hundreds of millions of dollars for fraudulent treatment.

Michael J. Ligotti, 46, was charged Wednesday with conspiracy to commit health care fraud and wire fraud, according to a U.S. Department of Justice press release. Ligotti made his initial appearance Friday before U.S. Magistrate Judge Bruce E. Reinhart in the Southern District of Florida.

The complaint against 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 unnecessary or didn’t exist. According to the press release, he billed the companies about $681 million worth of services. They paid out about $121 million.

“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,” said Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division.

Ligotti owned Whole Health in Delray Beach, a private clinic that offered addiction treatment, family care and urgent care, according to the release.

Along with Whole Health, Ligotti’s name appeared as the “Medical Director” for more than 50 other addiction treatment facilities and he allegedly signed over 136 orders for fraudulent tests, the release said.

According to the complaint, Ligotti would require patients from these treatment facilities to submit testing and treatments he authorized at Whole Health. Ligotti was then able to bill these patients’ insurance companies for fraudulent tests and treatments. Ligotti also allegedly ordered and conducted urinalysis (UA) tests and blood tests that were never used in patient treatment.

Along with the fraudulent tests, Ligotti allegedly billed the companies for psychiatric services and therapy sessions that never occurred, according to the release. Some patients were allegedly billed between $10,000 and $20,000 by Ligotti for a single day’s visit.

Additionally, the complaint alleges that Ligotti was prescribing large amounts of buprenorphine, a narcotic commonly used to fight opioid addiction, to patients who did not need it.