Florida Medical Doctor Convicted on $110M Addiction Treatment Fraud Billing Scheme

A South Florida doctor has been convicted by a federal jury for fraudulent billing of approximately $110 million for addiction treatment services.

Mark Agresti of Palm Beach was convicted of one count of conspiracy to commit health care fraud and wire fraud related to the billing, as well as 11 counts of health care fraud for billing that federal authorities said was medically unnecessary.

Agresti had been charged with the billing of services at West Palm Beach-based Good Decisions Sober Living (GDSL), where he was its medical director. GDSL, the government said, had been paid kickbacks to provide urinalysis drug testing to patients, which is a violation of Florida state law.

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The conviction is the second for the government to come out of the U.S. Department of Justice’s (DOJ) Sober Homes Initiative.

“This defendant, a medical doctor, was trusted to provide care to vulnerable patients,” DOJ Assistant Attorney Kenneth Polite Jr. said in a statement issued by the department. “Instead, he abused his position of trust in a multimillion-dollar fraud scheme. He took advantage of people seeking addiction treatment.”

Evidence introduced during the trial linked Agresti to standing orders for urinalysis drug tests for GDSL patients in exchange for a monthly fee. Agrest was also alleged to have had GDSL patients sent to his own medical practice, from which he could bill for services performed.

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The DOJ further contended that GDSL patients were required to submit urinalysis tests up to three or four times a week, which the department labeled as excessive in addition to being unnecessary. Each test cost up anywhere between $6,000 and $9,000, with hundreds being conducted per week and thousands per month.

The government said Agresti neither reviewed the drug tests nor used them to treat patients. Agresti was also accused of having done likewise at other West Palm Beach addiction treatment facilities where he provided services, resulting in thousands more fraudulent urinalysis tests.

“This defendant used his medical license to facilitate an egregious, multimillion-dollar fraud scheme that exploited vulnerable substance abusers,” U.S. Attorney Juan Antonio Gonzalez said in the statement.

Agresti is scheduled to be sentenced in April and faces a maximum penalty of 20 years in prison for the health care fraud and wire fraud conspiracy count, as well as 10 years for each count of health care fraud.

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