The former director of a residential addiction-recovery center in Florida faces more than eight years in prison and a nearly $32 million fine for his role in a massive fraud scheme, the U.S. Department of Labor (DOL) announced recently.
Mark G. Agresti was sentenced to 100 months in prison and 36 months of supervised release by the U.S. District Court for the Southern District of Florida in Miami, the DOL announced June 27. Agresti was also ordered to pay $31,041,938 in restitution, according to the announcement.
The court's judgement comes after a multi-agency investigation found Agresti, then the medical director for Good Decisions Sober Living (GDSL) in West Palm Beach, "submitted false and medically unnecessary tests for reimbursements to healthcare benefit plans," the DOL reports. Agresti and his co-defendants filed $106 million in fake claims to over 80 federal healthcare benefits programs and private insurance companies, according to the report.
Ali Khawar, acting assistant secretary for the Employee Benefits Security Administration (EBSA), said the sentencing "demonstrates that the U.S. Department of Labor and its federal partners in enforcement will hold people like this accountable.”
Federal investigators determined that from September 2011 to December 2015, Agresti and GDSL owner Kenneth Bailynson falsely billed benefits programs and insurance companies for fluid analysis tests on the center's residents, according to the report. Bailynson was found to have conspired with Stephanie Curran and Matthew Noel to bribe patients from other recovery centers in the area to have testing done at Good Decisions' lab, the DOL reports.
Bailynson, Curran and Noel, who previously pleaded guilty to conspiracy to commit healthcare fraud, face from 12 to 36 months in prison and restitution penalties from $8,673,925 to $31,041,938, according to the report.
“People who scheme to defraud healthcare plans and the companies that sponsor them increase the costs for everyone," Khawar said in the report, "and may make it more difficult for people who need these services – to improve their physical and mental health – to obtain them.”
Investigators with the Departments of Labor and Justice, the Federal Bureau of Investigations and the Internal Revenue Service conducted the investigation, the DOL reports.
