Owner of Closed Substance Use Treatment Facility in Florida Pleads Guilty to Conspiracy to Defraud Health Insurers
PHILADELPHIA – United States Attorney Jacqueline C. Romero announced that Terrence Livorsi, 68, of Glenside, Pennsylvania, pleaded guilty to charges of conspiracy to commit health care fraud arising from his operation of his company’s 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 fraudulently bill patients’ medical insurance for treatment that was not medically necessary.
Livorsi offered his company’s EAP services free of charge and marketed its 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 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's guilty plea should send a clear message to those seeking to build their financial empire off the despair of individuals battling addiction by committing health care fraud," said U.S. Attorney Jacqueline C. Romero. “The defendant's actions were illegal and unconscionable. Moreover, healthcare fraud impacts all of us by raising costs and compromising quality.”
“Over the course of years, Terrence Livorsi defrauded insurers of big money by using patients as pawns,” said Jacqueline Maguire, Special Agent in Charge of the FBI’s Philadelphia Division. “He had no compunction about referring all of these people to his own faraway treatment facility, some of whom didn’t even have substance abuse issues. Health care fraud is a costly, consequential federal crime and the FBI will continue to make these investigations a priority as we work to deter such criminal behavior.”
Livorsi was charged by Information filed April 11, 2023, and entered a plea of guilty on May 8, 2023. A sentencing hearing is scheduled for September 6, 2023 at 10:00 a.m.
The cases were investigated by the Philadelphia FBI Healthcare 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.