WEST PALM BEACH, FL – A federal court in Miami has sentenced the former medical director of a West Palm Beach residential addiction recovery center to prison and ordered more than $31 million in restitution paid as part of a healthcare scheme to obtain reimbursement for $106 million in false claims to more than 80 private insurance companies and federal healthcare benefit programs.
The U.S. District Court for the Southern District of Florida sentenced Mark G. Agresti to 100 months in prison, and 36 months of supervised release. The court also ordered Agresti and his co-defendants to pay $31,041,938 in restitution. The action follows a multi-agency investigation that included the U.S. Department of Labor’s Employee Benefits Security Administration. It determined Agresti, then the medical director of Good Decisions Sober Living, submitted false and medically unnecessary tests for reimbursements to healthcare benefit plans.
EBSA investigators found that – between September 2011 and December 2015 – Agresti and Good Decisions Sober Living owner Kenneth Bailynson falsely billed private insurance companies and federal healthcare benefit programs for reimbursement for fluid analysis used to evaluate the addiction recovery center’s residents. The schemes targeted dozens of employer-sponsored plans including the Amtrak Union Benefits Plan, the Bricklayers Insurance and Welfare Fund, and the Construction Workers Trust Fund.
The investigation also found Bailynson co-conspired with ...
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