Massive fraud, COVID, and mental health
The “Florida Shuffle” involving a $746 million sober home scam, a proposed permanent end to COVID mandates, the state of Florida’s mental health system, plus another Obamacare enrollment record. It’s all in this week’s Healthcare Digest.
COVID Mandates: Governor DeSantis announced last week that he wants the series of executive orders he issued during the pandemic that prohibited various federal COVID-19 mandates be made permanent through state law. His proposal includes permanently prohibiting COVID-19 vaccine passports in Florida; vaccine and mask requirements in all Florida schools; masking requirements at businesses; and permanently prohibiting employers from hiring or firing based on mRNA vaccinations. He is also proposing first amendment rights guarantees for medical professionals, ensuring no one loses their job or medical license for voicing their professional opinions or their personal religious views. Such mandates, he said, have “continuously proven ineffective.”
Health Insurance Fraud: Dr. Michael Ligotti of Delray Beach was sentenced earlier this month to 20 years in federal prison for his role in a massive nine-year insurance fraud scheme involving sober homes. Ligotti served as medical director for more than 50 sober homes, substance abuse treatment facilities, and clinical testing labs in the Palm Beach County area, often signing standing orders for expensive, medically unnecessary urine drug tests for patients at various addiction treatment facilities, according to a Justice Department release. He billed insurance companies more than $746 million for the bogus tests and addiction rehab of which about $127 million was paid.
Palm Beach County State Attorney Dave Aronberg described this type of case to ESPN as the “Florida Shuffle…where you go in and out of recovery, in and out of rehab centers, in and out of sober homes, milking the individual for their insurance until that person dies. Our current system isn’t really a recovery model, it’s a relapse model, where the big money is in relapse.”
State of Mental Health: The Tampa Bay Times reports that the state Commission on Mental Health and Substance Abuse is out with an interim report, calling for sweeping reforms to what it describes as a “patchwork” system of mental health care that is “complex and inequitable.” The Commission was formed following a statewide grand jury’s December 2020 report that labeled Florida’s mental health system “a mess.” The Times reports three key recommendations so far: to study expanding Medicaid for young adults, tracking patients in the system, and having the money follow the individual patient, not the program. The group’s final report is due September 1 to the Governor and legislative leaders.
Affordable Care Act Growth: Enrollment in health insurance provided through the Affordable Care Act grew by 13% in the 2023 open enrollment period that ended on January 15. About 15.9 million Americans by last count signed up through federal and state marketplaces, up from the 14.5 million in 2022. Florida once again had the greatest number of enrollees at 3.15 million, according to the latest CMS report.
LMA Newsletter of 1-23-23