Florida physician gets 8 years in prison, ordered to pay $31M for fake medical claims

A West Palm Beach, Fla.-based addiction recovery physician has been sentenced to prison and ordered to pay more than $31 million in restitution for his involvement in a scheme to be reimbursed for $106 million in fake medical claims, a federal court in Miami ruled June 28. 

Mark Agresti, MD, former medical director of the residential addiction recovery center Good Decisions Sober Living, was sentenced to 100 months in prison and 36 months of supervised release. He was ordered to pay $31,041,938 in restitution.

The sentencing follows a multiagency investigation that determined Dr. Agresti and the recovery center's owner, Kenneth Bailynson, falsely billed private payers and federal healthcare benefit programs for reimbursement for fluid analysis used to evaluate the addiction recovery center’s residents. 

Between September 2011 and December 2015, 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.

Mr. Bailynson was sentenced April 20 to 72 months in prison, followed by 36 months of supervised release. On June 24, he was ordered to pay $31,041,938 in restitution.

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