Palm Beach doctor found guilty of $110 million drug treatment fraud

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A federal jury has found that South Florida physician Mark Agresti illegally billed millions of dollars for medically unnecessary drug tests for patients at a sober living facility.

Miami Herald

A South Florida doctor faces decades in prison after a federal jury finds he illegally charged $110 million for drug tests deemed medically unnecessary for patients at a sober living facility .

On February 10, Mark Agresti was found guilty of one count of conspiracy to commit healthcare fraud and wire fraud in addition to 11 counts of healthcare fraud. health, the U.S. Attorney’s Office for the Southern District of Florida said in a statement.

Agresti is expected to be sentenced on April 21, facing up to 20 years in prison on the health care fraud and wire fraud conspiracy count, and 10 years on each count of health care fraud, a indicated the office.

It is the second conviction following a Justice Department initiative to crack down on those suspected of exploiting vulnerable patients seeking treatment for drug or alcohol addiction.

As medical director of Good Decisions Sober Living Inc., a sober home and lab in Palm Beach County, Agresti has agreed to provide standing orders for urinalysis drug testing for patients in exchange for a monthly fee, the office said.

Prosecutors say Agresti also had sober house patients sent to his medical office so that he could fraudulently bill for services for those patients from his own medical office.

Three or four times a week, patients were “required to submit to excessive and medically unnecessary urine drug tests as a condition of residency,” the office said, adding up to hundreds of drug tests per week. and thousands per month.

Each drug test can cost between $6,000 and $9,000, the bureau said, noting that Agresti has not reviewed drug test results and used them to treat patients.

The fraudulent activity occurred from September 2011 to December 2015 at the sober house and other drug treatment centers in the West Palm Beach area, authorities said.

“The defendant in this case exploited patients seeking drug treatment and pocketed the profits for years,” Deputy Director Luis Quesada of the Federal Bureau of Investigation’s Criminal Investigations Division said in the statement. “This conviction is a warning that fraudulent practices such as billing for medically unnecessary services come at a high cost,” he said.

Three other defendants, including sober house owner Kenneth Bailynson, have already been charged and have pleaded guilty to related charges related to the scheme, according to the office. The names of the other defendants are Stephanie Curran and Matthew Noel, according to a court document.

Attorneys for Agresti did not immediately respond to a request for comment.

“The office is closed with immediate effect. Patients, please call the office to retrieve your medical records,” Agresti’s medical practice website reads.

In November, Bal Harbor brothers Jonathan and Daniel Markovich were found guilty of defrauding private insurance companies of $112 million for drug treatment services that prosecutors said weren’t not provided or were unnecessary.

In 2018, the Justice Department uncovered a series of health care fraud cases accusing about 600 defendants nationwide of submitting $2 billion in fake bills to the Medicare program for seniors, to the TRICARE system for the military and to private insurance companies.

Of that total, about 125 defendants — Agresti included — were charged in South Florida with filing nearly $340 million in fraudulent claims.

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