A South Florida doctor, Mark Agresti of Palm Beach, has been convicted by a federal jury for his involvement in one of the largest addiction treatment fraud schemes in recent history. Agresti, who was the medical director of Good Decisions Sober Living (GDSL), a West Palm Beach-based addiction treatment facility, was found guilty of conspiracy to commit health care fraud and wire fraud, along with 11 counts of health care fraud. The fraudulent billing scheme totaled approximately $110 million, involving unnecessary and excessive addiction treatment services.
Fraudulent Billing and Excessive Testing
Federal investigators uncovered that Agresti orchestrated a scheme to bill government healthcare programs for medically unnecessary services at GDSL. One of the core elements of this addiction treatment fraud involved the excessive use of urinalysis drug testing. The government’s evidence showed that GDSL required patients to undergo drug tests three to four times weekly—far beyond what is considered medically appropriate or necessary. Each of these tests was billed at an inflated rate, ranging from $6,000 to $9,000 per test.
With hundreds of patients subjected to these tests multiple times per week, the volume quickly escalated to thousands of tests monthly. Despite the high frequency and cost of these drug tests, Agresti neither reviewed the results nor used them to guide patient care, demonstrating clear abuse of medical billing protocols. The excessive testing not only drove up healthcare costs dramatically but also placed undue burden on patients undergoing addiction treatment.
Kickbacks and Referrals to Private Practice
Prosecutors also revealed that Agresti received kickbacks from GDSL in exchange for ordering the excessive drug tests, a practice that violates Florida state law. In addition, Agresti was found to have referred patients from GDSL to his own medical practice, where he billed separately for additional services. This referral system enabled Agresti to generate even more fraudulent income while continuing to exploit vulnerable patients.
Further investigations uncovered that Agresti engaged in similar fraudulent practices at other addiction treatment centers in West Palm Beach. Thousands of additional unnecessary urinalysis tests were ordered and billed at these locations, further contributing to the scope of this widespread addiction treatment fraud.
DOJ’s Sober Homes Initiative and Government Response
This conviction is a significant outcome of the U.S. Department of Justice’s Sober Homes Initiative, a federal effort launched to combat fraud, abuse, and unethical conduct in addiction treatment and sober living facilities across the country. The initiative targets operators and providers who exploit individuals seeking recovery through deceptive and illegal practices.
DOJ Assistant Attorney Kenneth Polite Jr. emphasized the seriousness of the case, stating, “This defendant, a medical doctor, was trusted to provide care to vulnerable patients. Instead, he abused his position of trust in a multimillion-dollar addiction treatment fraud scheme.” U.S. Attorney Juan Antonio Gonzalez echoed these remarks, adding, “This defendant used his medical license to facilitate an egregious, multimillion-dollar fraud scheme that exploited vulnerable substance abusers.”
These statements highlight the federal government’s commitment to protecting patients and ensuring integrity in the addiction treatment industry by prosecuting those who commit addiction treatment fraud.
Impact on Patients and the Healthcare System
The consequences of this addiction treatment fraud extend beyond financial losses. Patients subjected to unnecessary testing and excessive medical procedures suffered from the psychological and emotional toll of invasive, frequent drug screenings. Many patients seek addiction treatment during vulnerable moments in their lives; having their trust violated by those responsible for their care further exacerbates the challenges of recovery.
Moreover, the fraudulent billing contributed to rising healthcare costs for government programs and private insurers. This places an added strain on the healthcare system and diverts resources away from legitimate patients in need of proper care. Cases like this underscore the importance of vigilance and accountability within addiction treatment centers to prevent exploitation and ensure that funds are used to provide genuine, evidence-based treatment.
Sentencing and Legal Consequences
Mark Agresti is scheduled to be sentenced in April and faces severe legal consequences for his role in this addiction treatment fraud. He could receive up to 20 years in prison for conspiracy to commit health care fraud and wire fraud, as well as up to 10 years in prison for each of the 11 counts of health care fraud.
The length and severity of Agresti’s sentence will likely reflect the gravity of his actions and the widespread impact of the fraudulent scheme on patients and the healthcare system. This case sends a strong message to healthcare providers who might consider abusing their medical licenses for financial gain.
A Call for Industry Reform and Oversight
This case serves as a stark warning to the addiction treatment industry about the dangers of fraudulent billing and unethical practices. Addiction treatment providers must uphold the highest standards of care, placing patient well-being above profit.
The Department of Justice’s continued efforts through the Sober Homes Initiative demonstrate the need for stronger oversight, transparency, and regulatory enforcement in addiction treatment and sober living facilities. Combatting addiction treatment fraud protects vulnerable populations and helps restore trust in the treatment system.
Patients and families seeking addiction treatment are encouraged to research providers thoroughly and report suspicious billing or treatment practices. Protecting the integrity of addiction recovery services benefits everyone and ensures that those struggling with substance use disorders receive honest, effective care.
