Tags: Menendez | Medicare | doctor | payment | Florida

Menendez Friend Received Millions From Medicare

Image: Menendez Friend Received Millions From Medicare Dr. Salomon Melgen

Thursday, 10 Apr 2014 06:22 AM

By Elliot Jager

A longtime friend of New Jersey Democratic Senator Robert Menendez took in the highest Medicare reimbursements in 2012 of any physician nationwide, The New York Times reported.

Dr. Salomon Melgen, a North Palm Beach, Fla., ophthalmologist, claimed $21 million in Medicare reimbursements. The eye doctor, and a Florida cardiologist, Dr. Asad Qamar — the No. 2 Medicare earner — are major Democratic donors, and have sought assistance from lawmakers when Department of Health and Human Services officials balked at the size of their reimbursement requests, the Times reported.

Melgen contributed over $700,000 to Senate Majority Leader Harry Reid's Majority PAC. Reid's super PAC then channeled $600,000 to Menendez's re-election campaign, the Times reported. The doctor was the biggest donor to the Menendez campaign last year.

The ophthalmologist is under billing scrutiny for using a single vial of Lucentis, a drug for macular degeneration, to treat several patients, while submitting reimbursement requests as if each patient was treated with a new pack. One vial comes with up to four times the dosage any single patient requires. Melgen received up to $8,000 per vial for which he paid $2,000. Moreover, the drug's manufacturer, pays physicians like Melgen rebates for using Lucentis, according to the Times.

The Menendez-Melgen connection has come under FBI investigation and agents twice
raided Melgen's offices. The New Jersey Democrat acknowledges that he twice interceded on Melgen's behalf with Medicare officials, according to the Times.

Menendez categorically denied allegations made by The Daily Caller that he'd used Melgen's private jet to fly to the Dominican Republican for trysts with underage prostitutes.

Lawyers defending the federal government in a lawsuit filed by Melgen to recoup $9 million in denied reimbursements, said his operation "seeks to game the system by seeking reimbursement of three to four times its actual costs," the Times reported.

Melgen hired Kirk Ogrosky, a former chief of the Justice Department's Medicare fraud task force, to defend him. "At all times, Dr. Melgen billed in conformity with Medicare rules," Ogrosky said in a statement, according to the Times.

By way of explaining the size of the bills he submitted, Qamar, who made $18 million in 2012, said his practice handles hospital-like procedures on an outpatient basis.

The Centers for Medicare and Medicaid Services released the names of the doctors in response to a lawsuit filed by The Wall Street Journal. The paper said a small fraction of physicians and medical providers accounted for a disproportionate amount of 2012 Medicare reimbursement.

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