A U.S. Justice Department investigation of kickback schemes targeted at substance abuse treatment facilities dubbed the “Sober Homes initiative” recently ended in the conviction of a Florida doctor.
According to evidence presented at trial, Mark Agresti, M.D., 59, of Palm Beach, unlawfully billed approximately $110 million of urinalysis (UA) drug testing services that were medically unnecessary for patients at Good Decisions Sober Living (GDSL). GDSL was paid kickbacks for providing patients to addiction treatment facilities in the West Palm Beach area.
Three other defendants, including GDSL’s owner Kenneth Bailynson, 45, of West Palm Beach, previously were indicted and pleaded guilty to related charges in connection with this scheme. He testified against Agresti during his recent trial, according to an article in the Palm Beach Post.
Agresti, who served as the sober home’s medical director, was convicted of one count of conspiracy to commit healthcare fraud and wire fraud, as well as 11 counts of healthcare fraud. He is scheduled to be sentenced on April 21 and faces a maximum penalty of 20 years in prison for the healthcare fraud and wire fraud conspiracy count, and 10 years for each count of healthcare fraud.
This is the second trial conviction to arise out of the Justice Department’s Sober Homes Initiative. In Oct. 2020, a federal district judge in Fort Lauderdale sentenced Sebastian Ahmed, 42, of Delray Beach to 210 months in prison and restitution of $4.2 million after he was convicted of conspiracy to commit healthcare fraud and wire fraud, five counts of healthcare fraud, conspiracy to commit money laundering, and eleven counts of money laundering.
According to DOJ, Agresti agreed to provide standing orders for drug tests for GDSL patients in exchange for a monthly fee. “Agresti also had GDSL patients sent to his medical office so he could fraudulently bill for services for these patients from his own medical practice. Patients at GDSL were required to submit to excessive, medically unnecessary urine drug tests as a condition of residency approximately three or four times per week. This added up to hundreds of UA drug tests per week and thousands per month.”
Evidence presented at trial showed that Agresti did the same thing at other addiction treatment facilities in the West Palm Beach area throughout the time of the charged conspiracy, resulting in hundreds of additional patients and thousands of additional fraudulent UA drug tests.
The Sober Homes Imitative was created by the DOJ in 2020 following the enactment of the Eliminating Kickbacks in Recovery Act (EKRA). That act prohibits the payment of remuneration in return for referring a patient to a recovery home, clinical treatment facility or laboratory.
Efforts to clean up Florida’s sober home industry are once again being made in Tallahassee. State Rep. Mike Caruso is sponsoring HB-479 which would do the following:
- Require service provider applicants to include names and locations of recovery residences in license application.
- Require service providers to provide DCF with record of recovery residences by specified date.
- Provide civil penalties.
- Require certified recovery residence administrators to demonstrate ability to meet specified requirements.
- Prohibit administrators from actively managing certain number of residents.
- Require service providers to return individual’s personal effects upon discharge.
The Health Law Offices of Anthony C. Vitale represents individuals and entities such as drug treatment facilities and laboratories accused of fraud by federal and/or state authorities. For more information, contact us at 305-358-4500 or email email@example.com.