In a sweeping case that highlights the deep vulnerabilities in the addiction treatment industry, a federal court in Southern Florida has sentenced a former medical director to more than eight years in prison for his involvement in a massive Substance Use Disorder False Claims conspiracy. The sentence is the harshest yet in the case, which has shaken the behavioral health care sector and exposed widespread fraud that siphoned millions from private insurers and federal health programs.
Dr. Mark Agresti, the former medical director of Good Decisions Sober Living, was sentenced to 100 months in prison and ordered to pay $31 million in restitution after being found guilty of orchestrating a fraudulent scheme that billed more than $106 million in unnecessary urinalysis testing.
The case was part of a multi-agency investigation led by the U.S. Department of Labor (DOL) and other federal partners, targeting what officials described as a long-running operation rooted in deception, kickbacks, and unethical billing practices.
Fraud Hidden Behind Addiction Treatment
The fraudulent activities occurred between September 2011 and December 2015, a time during which Good Decisions Sober Living submitted thousands of Substance Use Disorder False Claims for drug testing services that were medically unnecessary or altogether fabricated.
These claims targeted over 80 private health insurers and federal health care programs, defrauding them by disguising repeated and excessive urine drug screens as legitimate medical services. Investigators found that Agresti and his associates billed these tests at high frequencies, often with no clinical justification.
To keep the scam running, patients were recruited from other sober living homes like The Treatment Center of the Palm Beaches and Last Stop, often in exchange for kickbacks and bribes. These individuals were steered toward Good Decisions Sober Living under the pretense of receiving appropriate care.
Co-Conspirators Face Prison Time and Restitution
While Dr. Agresti’s sentence is the most severe, others involved in the Substance Use Disorder False Claims scheme have already faced judgment. The following individuals pleaded guilty and were sentenced in April:
- Kenneth Bailynson, Owner
Sentenced to 72 months in prison, 36 months supervised release, and $31 million restitution. - Stephanie Curran, Employee
Sentenced to 12 months and one day in prison, 36 months supervised release, and $11.3 million restitution. - Matthew Noel, Employee
Sentenced to 14 months in prison, 36 months supervised release, and $8.7 million restitution.
Authorities revealed that Bailynson conspired with Curran and Noel to pay illegal referral fees to other treatment centers, using financial incentives to channel patients toward services at Good Decisions where Substance Use Disorder False Claims could be submitted.
Florida’s Troubling Pattern of Health Care Fraud
The Agresti case is far from an anomaly in Florida. In fact, the state has become a frequent epicenter for Substance Use Disorder False Claims investigations, driven by a dense concentration of addiction treatment providers and lax oversight in some regions.
Just last year, two brothers were convicted in a separate South Florida case for fraudulently billing $112 million for bogus testing and therapy services. That case also included Paycheck Protection Program (PPP) bank fraud, underscoring the multiple fronts on which health care scams can occur.
These trends highlight the urgent need for greater accountability and regulatory enforcement in the behavioral health industry—not just in Florida, but nationwide.
Exploiting a Public Health Crisis
At the core of this case lies a deeply unsettling truth: that the opioid crisis and rising demand for addiction treatment are being exploited for financial gain. The Substance Use Disorder False Claims at the heart of this investigation diverted funds away from real patient care and into the hands of those abusing the system.
This type of fraud damages the integrity of treatment programs, increases insurance premiums, and undermines the trust between providers and patients. When treatment centers prioritize billing over outcomes, those most in need of recovery suffer the consequences.
Compliance Is Non-Negotiable for Providers
For addiction treatment providers across the U.S., this case serves as a stark warning. With the federal government cracking down on Substance Use Disorder False Claims, providers must ensure their operations are compliant with all billing, documentation, and patient care regulations.
Best practices include:
- Implementing routine compliance audits
- Avoiding any arrangements that could resemble kickbacks or patient brokering
- Clearly documenting medical necessity for all services provided
- Training staff regularly on Anti-Kickback Statute, False Claims Act, and other regulatory frameworks
Those who fail to comply face not only financial penalties but the possibility of criminal prosecution, as demonstrated in Agresti’s case.
A Turning Point for the Industry
With more than $82 million in restitution already recovered and 16.5 years of combined prison time issued before Agresti’s sentencing, this case marks a turning point in how fraud in the behavioral health space is investigated and prosecuted.
By aggressively pursuing individuals involved in Substance Use Disorder False Claims, authorities are signaling that patient exploitation and insurance fraud will be met with long-term consequences. For the industry to heal, ethical leadership, regulatory enforcement, and a commitment to quality care must come first.
Conclusion: Accountability in Addiction Treatment
The sentencing of Dr. Mark Agresti in the $106 million Substance Use Disorder False Claims case represents a major milestone in holding unethical providers accountable. It’s a signal to the entire behavioral health community that fraudulent behavior—no matter how sophisticated—will not go unnoticed.
As addiction treatment becomes more essential than ever, the integrity of care must be protected. Recovery isn’t just about the patient’s journey—it’s also about restoring trust in a system too often misused. And that trust begins with truth, transparency, and unwavering compliance.
