Jury finds sober house physician responsible in $31.3M medical insurance rip-off; sentencing set for April

FORT LAUDERDALE — Dr. Mark Agresti, who claimed he devoted his 30-year profession to serving to individuals fighting habit, on Thursday was convicted of 12 expenses of well being care fraud for utilizing his purchasers to perpetuate a $31.3 million insurance coverage rip-off.

The 59-year-old psychiatrist confirmed no emotion, however turned briefly and checked out his spouse, as U.S. District Decide Rodolfo Ruiz introduced the jury’s resolution that got here after roughly 2 ½ hours of deliberations following a three-week trial.

Agresti, who was as soon as director of psychiatry on the former Columbia Hospital in West Palm Seaside, faces a potential decades-long jail sentence after the jury agreed he ordered 1000’s of medically pointless assessments when he served as medical director of Good Selections Sober Dwelling.

Federal brokers take away proof from an workplace on the Inexperienced Terrace condominium, the place the condos have been transformed to a sober dwelling house, September11, 2014, in West Palm Seaside. The raid led to the closure of Good Selections Sober Dwelling and later to the convictions of Kenneth Bailynson and Dr. Mark Agresti in a $31.3 million heath care fraud scheme.

Physician’s protection: ‘It blows my thoughts’: Physician tells court docket sober-home proprietor duped him into $31 million insurance coverage fraud

Proprietor speaks: “I am grasping”: Ex-sober house operator remorseless in testifying in opposition to physician

Sentencing scheduled for April 21

The Palm Seaside resident is the newest of dozens of people that had been prosecuted in reference to Palm Seaside County’s once-thriving illicit sober house trade.

Whereas federal prosecutors initially requested that Agresti be taken to jail to await sentencing on April 21, they relented once they discovered his father is in a hospice and close to dying. Ruiz mentioned he did not consider Agresti was a flight threat and there was no have to jail him.

Agresti’s protection crew, who tried to steer jurors that Agresti was duped by unscrupulous sober house proprietor Kenneth Bailynson, mentioned they had been disenchanted by the decision.

“We felt that Dr. Agresti was not responsible,” mentioned Richard Lubin, who represented the doctor together with attorneys Greg Rosenfeld and Amy Morse. “We are going to collect to determine what our subsequent step will likely be.”

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Throughout closing arguments on Thursday, Rosenfeld argued that whereas Agresti made errors, he didn’t commit any crimes.

“The federal government did a unbelievable job of proving that Dr. Agresti was negligent, perhaps even grossly negligent, however that’s not the problem on this case,” he mentioned.

Federal prosecutors countered that Agresti knew precisely what Bailynson was doing, knew it was unlawful and helped him anyway.

“They’re asking you to consider the neatest individual within the room, a physician, was tricked,” mentioned Assistant U.S. Legal professional James Hayes.

Kenneth Bailynson used the Green Terrace condominium off of Georgia Avenue in West Palm Beach, seen here in 2014, as a sober home for his Good Decisions Sober Living operation. A federal jury later found both Bailynson and Dr. Mark Agresti, Good Decisions' medical director, guilty of $31.3 million in health care fraud.

Kenneth Bailynson used the Inexperienced Terrace condominium off of Georgia Avenue in West Palm Seaside, seen right here in 2014, as a sober house for his Good Selections Sober Dwelling operation. A federal jury later discovered each Bailynson and Dr. Mark Agresti, Good Selections’ medical director, responsible of $31.3 million in well being care fraud.

The sober house that Bailynson operated out of a rundown condominium advanced on Georgia Avenue in West Palm Seaside wasn’t attempting to assist individuals beat their addictions, Hayes mentioned.

“It was used as a farm to reap urine samples and generate profits off of it,” he mentioned.

The profitable operation trusted Agresti and his prescription pad. Insurance coverage firms wouldn’t pay for costly urine assessments until Agresti ordered them.

And Agresti ordered 1000’s of them throughout the 23 months he served as medical director of the operation that was shut down in September 2014 after an FBI raid.

Residents had been examined not less than 3 times per week. The assessments Agresti ordered weren’t easy, cheap drug screens that will instantly present whether or not a resident had relapsed.

As an alternative, Agresti ordered costly laboratory assessments and requested that every urine pattern be screened for as many as 80 various kinds of medication.

Whereas insurers would pay about $300 for the fast assessments, they’d write checks for a mean of $1,500 for the extra complete screens, Bailynson testified.

As a result of a lab needed to course of the advanced assessments, the outcomes weren’t out there for so long as 5 days. But Agresti continued to order further assessments earlier than the outcomes of earlier ones had been out there.

“It is unnecessary to order a second take a look at whenever you haven’t seen the outcomes of the primary take a look at, after which order a 3rd take a look at whenever you haven’t seen the outcomes of both of the opposite two,” Hayes mentioned.

Physician mentioned assessments deterred drug use. Prosecutors say he by no means learn outcomes.

Whereas testifying in his personal protection this week, Agresti mentioned the assessments had been to function a deterrent. Realizing they’d be examined recurrently, residents had been much less more likely to relapse, he mentioned.

He acknowledged that he didn’t overview the take a look at outcomes. That was left to teenage staffers at Good Selections. Any resident who examined optimistic was requested to go away.

Once more, Hayes mentioned, Agresti’s clarification for ordering the assessments after which not reviewing the outcomes defies logic.

“It’s unreasonable and is unnecessary that a physician would order the assessments and by no means overview the outcomes,” he mentioned.

Rosenfeld insisted that the federal government’s case was constructed on the testimony of people that had a lot to realize by testifying in opposition to Agresti.

Kenneth Bailynson, seen here in the foreground at right, used the Green Terrace condominium off of Georgia Avenue in West Palm Beach, seen here in 2014, as a sober home for his Good Decisions Sober Living operation. A federal jury later found both Bailynson and Dr. Mark Agresti, Good Decisions' medical director, guilty of $31.3 million in health care fraud.

Kenneth Bailynson, seen right here within the foreground at proper, used the Inexperienced Terrace condominium off of Georgia Avenue in West Palm Seaside, seen right here in 2014, as a sober house for his Good Selections Sober Dwelling operation. A federal jury later discovered each Bailynson and Dr. Mark Agresti, Good Selections’ medical director, responsible of $31.3 million in well being care fraud.

Bailynson, who pleaded responsible to conspiracy to commit well being care fraud, readily admitted to the jury that he was testifying in opposition to Agresti in hopes of decreasing a promised 10-year jail sentence.

Eric Snyder, proprietor of the previous Actual Life Restoration, testified in opposition to Agresti, who additionally served a medical director of the Delray Seaside remedy middle. Snyder was handed a 10-year jail time period in 2019 after pleading responsible to conspiracy to commit wire fraud. He has been allowed to stay free so he can testify in opposition to others.

“To consider Dr. Agresti dedicated fraud, you must consider a bunch of people that had been convicted of fraud,” Rosenfeld instructed the jury.

Additional, he argued that the federal government cherry-picked affected person recordsdata and lab assessments to forged Agresti within the worst mild potential. Additionally, he mentioned, Agresti had no monetary motive to order extra assessments.

In contrast to Bailynson, who pocketed $15 million from the scheme, Agresti was paid a month-to-month wage. Whereas it elevated because the variety of residents dwelling at Good Selections swelled from 25 to almost 250, it wasn’t primarily based on the variety of assessments he ordered, Rosenfeld mentioned.

Assistant U.S. Legal professional Amanda Perwin mentioned Agresti earned almost $900,00 whereas working at Good Selections and a few 10 different sober houses and remedy facilities in Palm Seaside County.

Ken Bailynson leaves court after a hearing Tuesday morning, October 20, 2015, during a hearing into charges that he profited off the patients in his sober homes.

Ken Bailynson leaves court docket after a listening to Tuesday morning, October 20, 2015, throughout a listening to into expenses that he profited off the sufferers in his sober houses.

Nonetheless, Rosenfeld mentioned, these numbers had been inflated. His internet earnings from his work as a medical director on the varied areas was $428,000, he mentioned. Of that, about $59,000 got here from Good Selections.

Rosenfeld insisted that Agresti was a compassionate psychiatrist who received caught up in a chaotic scenario that spiraled uncontrolled.

“He instructed you and he was sincere that he was in over his head,” Rosenfeld mentioned. “He instructed you, ‘I’m an fool. I didn’t imply to. I needed to assist individuals.’ ”

Such admissions, notably for a physician, are exhausting to make, he mentioned.

However, Hayes countered, Agresti might have sounded the alarm as soon as he realized Bailynson was utilizing individuals who had been fighting habit to get wealthy.

“The tragedy of this case is Dr. Agresti,” Hayes mentioned. “He had rather a lot to supply and he didn’t do it.”

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This text initially appeared on Palm Seaside Publish: Sober house physician responsible in $31M insurance coverage fraud over urine assessments

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