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Date: 02-14-2024
Case Style:
Case Number: 2:23-CR-147
Judge: Gene E.K. Pratter
Court: The United States Court for the Eastern District of Pennsylvania (Philadelphia County)
Plaintiff's Attorney: The United States Attorney’s Office in Philadelphia
Defendant's Attorney:
Description:
Terrence Livorsi, 69, of Glenside, Pennsylvania, was sentenced to 26 months’ imprisonment and two years of supervised release, and ordered to pay $287,654.72 in restitution, a $10,000 fine, and $100 special assessment for conspiring to commit health care fraud, arising from his operation of an Employee Assistance Program (“EAP”). Livorsi used the EAP to funnel patients to addiction treatment at facilities and programs that he owned in Florida, in order to bill patients’ medical insurance for treatment, including treatment that was not medically necessary.
Livorsi offered his EAP services free of charge and marketed the services mainly to public sector labor unions in New Jersey. Livorsi and his EAP encouraged union officials and representatives to call when a union member was in distress or facing workplace discipline. Upon referral of a union member for EAP services, Livorsi and/or an employee of the EAP collected information from the person, including asking the prospective patient about his or her use of alcohol or drugs. Many prospective patients did not have substance use disorders but were nevertheless fraudulently referred to Recovery Institute of South Florida (“RISF”), a substance use treatment facility that Livorsi also owned and operated. Patients were pressured to fly to Florida immediately for treatment at RISF, allegedly to save their jobs. The people that Livorsi and his staff members referred to RISF were not told that Livorsi owned RISF or that he would benefit financially by billing their health insurance.
From at least January 2014 until RISF closed in April 2018, it was the business of Livorsi’s EAP to send patients to treatment at RISF. RISF depended on the EAP to refer patients for treatment and made money by billing insurers for those referred patients. The EAP, which did not charge anyone for its services, depended on RISF to finance its operations. As the sole owner of both RISF and the EAP, Livorsi controlled every aspect of their operations, including the finances and bank accounts of both organizations. Livorsi directly profited when RISF profited. Livorsi directed RISF to pay bonuses to his staff, including himself, for admissions to RISF that the employee had procured. Although he was not a licensed caregiver and was infrequently present at RISF, Livorsi exercised control over when patients could be discharged from RISF and would keep patients as long as possible to maximize the opportunities to bill insurance.
Livorsi was charged by an information filed April 11, 2023, and entered a plea of guilty on May 8, 2023.
“Terrence Livorsi’s scheme was to use an Employee Assistance Program he owned to funnel patients to a drug treatment facility that he also owned — whether they had substance abuse issues or not — keep them there as long as possible, and profit,” said U.S. Attorney Romero. “He gave no thought to these people’s wellbeing, or their lives and livelihoods, just the money he could bilk from their insurance plans. Health care fraud is an incredibly costly crime and a high priority for the Department of Justice. That’s why we and the FBI will continue to work together to hold fraudsters like Terrence Livorsi accountable.”
The case was investigated by the FBI Philadelphia Health Care Fraud Task Force, which includes agents from the Pennsylvania Attorney General's Office and the Philadelphia Police Department, and the Employee Benefit Security Administration of the United States Department of Labor, and is being prosecuted by Assistant United States Attorney Elizabeth Abrams.
Outcome:
Plaintiff's Experts:
Defendant's Experts:
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