A Southern Florida federal court has handed down its heftiest sentence yet in a $106 million substance use disorder false claims conspiracy case.
Judge Rodolfo Ruiz II sentenced Mark Agresti, formerly the medical director of Good Decisions Sober Living, to 100 months of prison time and to pay about $31 million in restitution for his role in a scheme that defrauded 80 private health insurance companies and federal health care programs, according to a news release from the U.S. Department of Labor (DOL).
The investigation and subsequent trials already generated $82 million in ordered restitution and 16.5 years’ worth of prison sentences before Agresti’s sentence.
A multi-agency false claims investigation that included DOL found that Agresti and others involved with Good Decisions Sober Living submitted $106 million of false and medically unnecessary urinalysis drug tests for reimbursements to health plans from September 2011 to December 2015.
Good Decisions Sober Living owner Kenneth Bailynson and Good Decisions Sober Living employees Stephanie Curran and Matthew Noel, who plead guilty to the charges, were sentenced before Agresti.
Here are the sentences for these three defendants:
— Kenneth Bailynson, sentenced on April 20: 72 months in prison, 36 months of supervised release and about $31 million in restitution
— Stephanie Curran, sentenced on April 19: 12 months and one day in prison, 36 months of supervised release, and $11.3 million of restitution
— Matthew Noel, sentenced on April 19: 14 months in prison, 36 months of supervised release and $8.7 million of restitution.
The investigation also found Bailynson co-conspired with Curran and Noel, who paid kickbacks and bribes to recruit patients from various sober homes in the area such as the Treatment Center of the Palm Beaches and Last Stop to get testing at Good Decisions Sober Living, according to the release.
Agresti was found guilty of one charge of conspiracy to commit health care fraud and 11 charges of health care fraud after entering a not guilty plea, the release states.
This is not the first fraud case in the behavioral health sector coming out of Florida that Behavioral Health Business has covered.
In November, a South Florida jury found two brothers fraudulently billed $112 million in testing and therapy services at two separate facilities on top of bank fraud related to the Paycheck Protection Program.
Companies featured in this article:
Good Decisions Sober Living, U.S. Department of Labor, U.S. Labor Department