From his Miami Jail Cell, Dr. Melgen Awaits Trial for $105 Million Medicare Fraud By Tod Aronovitz | 04/21/15 | 0 Comment

Alleged lies have apparently caught up with North Palm Beach ophthalmologist Salomon Melgen. Accused of lying to the federal government about Medicare claims and lying to his patients by unlawfully diagnosing them with macular degeneration, federal prosecutors have refused to negotiate bond with the multimillionaire native of the Dominican Republic while he awaits trial on 76 charges of bilking Medicare out of $105 million, filing false claims, and making false statements, The Palm Beach Post reported.

Miami medical malpractice lawyer Tod Aronovitz has followed this story since Dr. Melgen has been the subject of a criminal investigation for overbilling Medicare through his use of Lucentis, a drug that treats macular degeneration at a cost of $2,000 per vial. The most recent update on ARONOVITZ Law Blog last April reported Dr. Melgen was paid over $20 million in Medicare reimbursements in 2012—the highest amount of any doctor paid by Medicare that year. Dr. Melgen admitted to no wrongdoing due to a controversial technicality on how the drug was administered and subsequently billed by his practice, Vitreo Retinal Consultants.

It has been speculated that bond has not been set for the 61-year-old in the hopes that he’ll cooperate in the prosecution of his longtime friend—U.S. Sen. Robert Menendez, D-N.J. in a separate public corruption case involving Medicare. Earlier in April, Dr. Melgen had pleaded not guilty along with Sen. Menendez after being indicted, and was released on $1.5 million bail in that matter.

Regarding that case, a recent story in the New York Times, “Florida Doctor Linked to Sen. Robert Menendez Indicted for Medicare Fraud,” said that shortly after Medicare’s auditors identified about $9 million in over-payments to Dr. Melgen as early as June 2009, Sen. Menendez instructed his staff to call Dr. Melgen and help him.

The incident was the first in a series of efforts by Sen. Menendez to try to influence efforts to recoup payments to Dr. Melgen, according to the indictment. The Senator’s office allegedly advocated for Dr. Melgen with CMS to relieve the doctor of his billing issues. Prosecutors have also argued that the Senator lobbied federal officials for contracts and projects that would enrich Dr. Melgen.

Over the years, Dr. Melgen made more than $1 million worth of campaign contributions to Sen. Menendez, gave the Senator free trips aboard his jet and vacations at his villa, and presented him with other gifts.

In Dr. Melgen’s case, the government found he had diagnosed and treated patients for macular degeneration when, often, there was nothing wrong with their eyes. According to the indictment, from January 2008 through December 2013, he submitted $190 million in Medicare claims and was reimbursed for $105 million.

If convicted, Dr. Melgen faces up to 10 years in prison on each of the 46 healthcare fraud counts. He would also face up to five years in prison on each of the 19 counts for filing false claims and 11 counts of making false statements if convicted.

Dr. Melgen’s attorneys asked U.S. Magistrate Judge James Hopkins to allow the doctor to be transferred from the Palm Beach County Jail to a federal prison in Miami. Judge Hopkins agreed, and that is where Dr. Melgen will now be housed before his trial.

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