Dr. Salomon Melgen made and lost millions by multi-dosing elderly patients

Dr. Salomon Melgen’s practice of using a single vial of a drug to treat multiple elderly patients for a wet macular degeneration went from being a bonanza to a bust, according to those who testified Wednesday in the Palm Beach County ophthalmologist’s trial on 76 charges of health care fraud.

Dr. Salomon Melgen, 62, arrives at the federal courthouse in West Palm Beach this week.(Lannis Waters / The Palm Beach Post)

When the U.S. Supreme Court two weeks ago refused to hear Melgen’s appeal in his long-running dispute with federal health regulators, it dashed his hopes of recouping millions he repaid Medicare when it claimed he wrongly used one vial of the pricey drug Lucentis to treat as many as four patients, a practice known as multi-dosing.

But federal prosecutors, who claim Melgen bilked Medicare out of as much as $105 million by multi-dosing, misdiagnosing and mistreating scores of elderly patients, said millions more are at stake.

The high court’s decision means Melgen won’t be able to get back the $8.9 million he repaid Medicare for multi-dosing patients at clinics in West Palm Beach, Wellington, Delray Beach and Port St. Lucie in 2007 and 2008. But, Medicare officials also want the wealthy, politically-connected retinal specialist to repay another roughly $32 million for multi-dosing patients from 2009 to 2013.

An attorney, whose Washington-based firm has been paid about $5 million to represent Melgen in his unsuccessful legal battle with the U.S. Department of Health & Human Services, told a federal jury that Melgen is appealing the agency’s claims that he owes it additional money. The appeals, attorney Alan Reider acknowledged, could stretch on for years.

Melgen’s attorneys – including one that works for the same Washington, D.C. law firm as Reider – argued that Melgen’s practice of multi-dosing didn’t cost the Medicare program a dime. Had Melgen bought separate vials of Lucentis for each of his patients, the agency would have reimbursed Melgen roughly $2,000 for each one.

But, prosecutors countered, the practice was lucrative for Melgen. Instead of buying separate vials of Lucentis for three or sometimes four patients, he bought one. But he was reimbursed as if he bought one for each patient.

That means if he used one vial to treat three patients, instead of getting back roughly $2,000 for a single vial, he got back about $6,000. If he used it to treat four patients, he got nearly $8,000.

The trial, which began last month, continues today. Melgen also faces corruption charges in New Jersey along with his longtime friend, U.S. Sen. Robert Menendez. His multi-dosing of Lucentis, and Menendez’s attempts to intervene in his dispute with federal regulators, figure into the prosecution’s case there as well.

 

Melgen almost gets to head home to await trial on dozens of health-care fraud charges

UPDATE: Federal prosecutors on Tuesday asked that the U.S. magistrate’s decision to allow Melgen to return home be put on hold until the matter is reviewed by U.S. District Judge Kenneth Marra. Magistrate James Hopkins granted the request which means Melgen will have to call off the moving vans.

After spending more than a year living in his daughter’s Palm Beach Gardens condo, Dr. Salomon Melgen is headed back to his sprawling house on the Intracoastal Waterway to await trial on charges that he defrauded Medicare out of as much as $105 million.

picture-dr-salomon-e-melgen-picture
Salomon Melgen

In an order signed this week, U.S. Magistrate James Hopkins said he is no longer concerned that living along the waterway increases the chances the ophthalmologist will flee to his native Dominican Republic. Further, Hopkins ruled that Melgen, who also faces corruption charges in New Jersey with his longtime friend U.S. Sen. Robert Menendez, can leave his house near Juno Beach from 9 a.m. to 9 p.m. without an escort. But, he said, he must continue to wear an ankle monitor.

In his order, Hopkins noted that Melgen would have gone to trial last month had federal prosecutors shared their witness list with the Melgen’s attorneys as they were required to do under court rules. U.S. District Judge Kenneth Marra in August reluctantly delayed the trial until next year saying the failure to share the information could have denied Melgen a fair trial.

Melgen and Menendez, a New Jersey Democrat, were indicted in April 2015 on corruption charges. Prosecutors claim Melgen showered Menendez with campaign contributions, hotel stays, free trips and other gifts. In exchange, they claim, Menendez lobbied federal agencies to help Melgen in an ongoing dispute over his Medicare billing and other matters, including bringing girlfriends into the country.

Weeks after he was charged in New Jersey, Melgen was charged here with more than 70 health-care related fraud charges in connection with clinics he operated in West Palm Beach, Wellington, Delray Beach and Port St. Lucie. Prosecutors claim he falsely diagnosed and treated scores of elderly patients for macular degeneration. They claim he double-billed Medicare by using one vial of Lucentis, a drug used to treat the malady that causes blindness, to treat multiple patients.

Melgen denies the charges. Before his release from the Palm Beach County jail in July 2015, he was forced to pledge all of his family’s assets – then estimated at $18 million – to secure his release. Since he was ordered to leave his home as part of the original bond deal, Melgen has sold his boat and jet, his attorneys said.

PBC eye doctor Salomon Melgen needs $2 million more to pay defense team

Prohibited by court order from tapping into his fortune, Palm Beach County ophthalmologist Dr. Salomon Melgen is running out of money to pay lawyers to represent him on charges that he bilked Medicare out of as much as $108 million.

Dr. Salomon Melgen exits the Palm Beach County jail with his wife Flor, left, and daughter, Melissa, right, in July. (Damon Higgins / The Palm Beach Post)
Dr. Salomon Melgen leaves the Palm Beach County jail with his wife Flor, left, and daughter, Melissa, right, in July 2015. (Damon Higgins / The Palm Beach Post)

In court papers filed this week, Melgen’s lawyers asked U.S. District Judge Kenneth Marra to let the physician use $2 million to pay mounting legal bills which they described as “substantial.”

In addition to facing 76 counts of health-care fraud and related charges in West Palm Beach, Melgen is charged in New Jersey with his longtime friend, U.S. Sen. Robert Menendez, in connection with what federal prosecutors describe as a mutually beneficial bribery scheme. He is also continuing to challenge the Centers for Medicare & Medicaid Services about his use of a single vial of Lucentis to treat multiple patients for macular degeneration – a practice known as “multi-dosing.”

“These are three complex and highly contested cases involving extensive motion practice and briefing,” his attorney Matthew Menchel and Kirk Ogrosky wrote, explaining their client’s need for cash.

With federal prosecutors describing the 61-year-old native of the Dominican Republic as a flight risk, U.S. Magistrate James Hopkins last year made sure Melgen couldn’t get his hands on his money, boats or private jet before allowing him to be released from jail. Hopkins ordered him and his family to post a whopping $18 million bond package. To assure his cash was off-limits, Hopkins appointed an escrow agent to pay his personal expenses, including his $2.3 million waterfront home in Captain’s Key near Juno Beach.

In making the request, Menchel and Ogrosky emphasized that Melgen, who treated hundreds of primarily elderly patients at eye clinics in West Palm Beach, Wellington, Delray Beach and Port St. Lucie, won’t have access to the $2 million. It will be paid directly into one of the lawyer’s trust accounts, they said.

“Releasing funds for the purpose of allowing him to pay counsel will not alter his incentives for appearing at trial, because the released funds will not be available for Dr. Melgen’s personal use,” they wrote.