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.
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.
The U.S. Supreme Court, by a 5-3 vote, on Monday threw out a Texas abortion law that opponents claimed was an end-run around the landmark Roe v. Wade decision that established a woman’s right to choose.
The decision is expected to have an impact on efforts in Florida to stop a restrictive abortion law from taking effect July 1. At a hearing Wednesday in Tallahassee, Planned Parenthood affiliates statewide will ask U.S. District Judge Robert Hinkle to issue an injunction, blocking the implementation of the measure that stripped funding from chapters throughout the state and, they claim, increased the state’s control over abortion.
In today’s much-anticipated decision, the nation’s high court ruled that the Texas abortion law created an undue burden on women seeking to exercise their constitutional rights.
The measure required doctors who perform abortions to have admitting privileges at local hospitals and required clinics to meet the same standards as outpatient surgical centers. Less than a dozen clinics, mostly in urban parts of the state, could meet the requirements, leaving tens of thousands of Texas women without access to reproductive health care, opponents said. Supporters claimed it was to keep women safe.
“We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes,” Justice Stephen Breyer wrote in an opinion joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan. Justices Clarence Thomas and Samuel Alito and Chief Justice John Roberts dissented.
In Breyer’s majority opinion, he noted that the law purported to cure an ill that didn’t exist. Quoting from a lower court decision, he wrote: “The great weight of evidence demonstrates that, before the act’s passage, abortion in Texas was extremely safe with particularly low rates of serious complications and virtually no deaths occurring on account of the procedure.”
Ginsburg, in a separate concurring opinion, underscored statements from the American
College of Obstetricians and Gynecologists that called abortion “one of the safest medical procedures performed in the United States.”
To hinder access to it, as the Texas law sought to do in the guise of protecting women, would endanger women instead, she wrote. “When a State severely limits access to safe and legal procedures, women in
desperate circumstances may resort to unlicensed rogue practitioners, faute de mieux, at great risk to their health and safety,” she wrote.
Denouncing the ruling, the U.S. Conference of Catholic Bishops, disagreed. “Abortion claims the lives of unborn children, and too often endangers their mothers, as well,” Deirdre McQuade, assistant director for pro-life communications for the Catholic bishops said in a statement. “This ruling contradicts the consensus among medical groups that such measures protect women’s lives.”
In a dissent, Thomas said the high court has once again rewritten the constitution to allow abortion clinics to thrive, unchecked. “I write separately to emphasize how today’s decision perpetuates the Court’s habit of applying different rules to different constitutional rights — especially the putative right to abortion,” he wrote.
West Palm Beach civil rights attorney Jim Green, who is representing Planned Parenthood in its battle to overturn Florida’s recently-passed abortion law, said the “undue burden” test that sunk the Texas law will play a key role in his arguments Wednesday to Hinkle.
“The question is, are these restrictions necessary, and the court held that they obviously weren’t,” he said. That decision could bolster his position that Florida’s law is yet another attack on women’s reproductive freedoms.
Florida’s law cut federal funding Planned Parenthood received through the state for non-abortion services, changed the definition of gestation and gave state workers the right to inspect at least 50 percent of medical records at abortion clinics. None of the provisions make women safer, Green said.
They simply create confusion, uncertainty and invade women’s privacy as part of efforts to make it more difficult for women to get abortions, he said.
In court papers, state officials disagreed. They claim Planned Parenthood has no constitutional right to government money. Further, they said, they always had the right to inspect patient records. The definition of trimesters was changed to clarify, not obfuscate, they said.
Florida officials weren’t immediately available for comment on what effect, if any, the high court’s decision would have on the state’s case.
A Port St. Lucie man, who is serving two life sentences for bludgeoning his parents to death with a hammer in 2011 when he was 17, will have a chance to argue that he should one day be allowed to live outside prison walls.
As it has done for others convicted of committing heinous crimes when they were under 18, the 4th District Court of Appeal on Wednesday ruled Tyler Joseph Hadley, now 22, should benefit from a 2012 U.S. Supreme Court decision that outlawed life sentences without parole for juveniles. The youths deserve special consideration because their brains aren’t fully developed, act impetuously and they are amenable to rehabilitation, the high court ruled.
In response to the ruling, the Florida Legislature passed a law that allows life sentences for juveniles. But, a judge must make certain findings, the West Palm Beach-based court found.
Because Hadley was sentenced in 2014, before the law went into effect, 19th Judicial Circuit Judge Robert R. Makemson had no way of following it, the appeals court wrote. While crediting the judge for trying his best, it said he erred by justifying the life sentence by saying Hadley had a previously been convicted of a capital crime. There is no evidence of that, the court wrote. Further, Makemson was required to consider possible alternatives to a life sentence.
Almost apologetically, the appeals court wrote: “We are therefore compelled to reverse and remand for resentencing.” Under the law, the minimum sentence would be 40 years and any sentence would be reviewed after 25 years.
The murders attracted national attention because of their brutality and callousness. After killing his parents, Hadley had a keg party, locking their bloodied bodies in a bedroom.
Claiming lawyers representing Dontrell Stephens improperly played the race card to win a $22.4 million verdict against the Palm Beach County Sheriff’s Office and Deputy Adams Lin, sheriff’s attorneys on Monday will ask a federal magistrate to reduce the award.
Throughout the trial that ended in February, Stephens’s lawyers repeatedly implied that the 2013 shooting that left the 22-year-old West Palm Beach man paralyzed from the waist down was racially motivated, sheriff’s attorneys Summer Barranco and Richard Giuffreda contend in court papers.
Stephens’ attorneys made reference to the “Black Lives Matter” movement, which grew in response to police shootings of black men throughout the nation, Barranco wrote.
“It was clear that (Stephens’) counsel wanted the jury to see this case as another one of those egregious cases they had seen in the media where a cop shot an unarmed young black man for no good reason,” she wrote.
The racial overtones inflamed the jury, spurring them to act on passion and prejudice rather than reason, she claims.
Further, she wrote, while Stephens may be paralyzed, he is not bed-ridden nor does he require round-the-clock nursing care.
“The testimony in this case showed … he was actually able to do quite a lot for himself,” Barranco wrote, pointing out that he can transfer himself from a bed to a wheelchair and can wheel himself around without assistance.
Attorney Jack Scarola, who represents Stephens, scoffed at Barranco’s attempt to put what he called “a positive spin” on Stephens’ injuries. “The cold harsh reality is that a healthy, active 20-year-old man was sentenced to over half a century in a wheelchair, unable to move from the waist down,” he wrote.
Lin shot Stephens seconds after stopping him for riding his bicycle erratically in morning rush-hour traffic on Haverhill Road. The shooting was captured on a video camera on Lin’s dashboard.
In closing arguments, Scarola told jurors that “Dontrell Stephens’ life mattered.” If Barranco or Giuffreda didn’t like it, they should have objected at the time, he wrote.
The verdict was rendered by a “intelligent, attentive and diligent jury that was fully qualified to assess the damages sustained by Dontrell Stephens,” he wrote. Contrary to Barranco’s assertions, he insisted they weren’t driven by passion or prejudice but powerful facts.
The hearing before U.S. Magistrate Barry Seltzer is to begin at 2 p.m.
The Palm Beach County Sheriff’s Office has agreed to pay $300,000 to settle a lawsuit filed by the family of a 39-year-old mentally ill Royal Palm Beach man who was shot by an off-duty deputy when he wandered into the officer’s garage.
A homeowner’s insurance company for Deputy Joshua McGehee agreed to pay another $300,000 to Aldo Alvarez, who survived the May 2013 shooting, said Stuart Kaplan, who represents the Alvarez family in the lawsuit filed in U.S. District Court.
The settlement came as Kaplan pressed the agency to release records that he claimed would show McGehee was unfit to work as a law enforcement officer.
In court papers, Kaplan claimed that McGehee suffered from Tourette’s syndrome or some other “psychological and/or neurological disorder,” but was hired because his mother is Sheriff Ric Bradshaw’s administrative assistant.
Routine psychological tests were waived because of McGehee’s connection to Bradshaw, Kaplan claimed in court papers.
Lawyers for the sheriff’s office weren’t immediately available for comment.
Alvarez’s parents hope to use the money to get their son vocational training so he may one day live independently, Kaplan said.
Charged with battery on a law enforcement officer and burglary with assault or battery after he was shot six times by McGehee, Alvarez was declared incompetent to stand trial. While no longer on house arrest, he can’t leave his house without his mother and father, according to terms set by Palm Beach County Circuit Judge Joseph Marx.
At a minimum, Kaplan said he is hoping to relax that restriction. He said he will also try to persuade state prosecutors to drop the charges in light of the settlement of the civil lawsuit. The prosecution is on hold until psychologists agree Alvarez is capable of understanding the charges he faces.
McGehee, who lived across the street from Alvarez and his parents, claimed he was forced to shoot. Alvarez, he claimed, entered his garage, cornered him and ignored his repeated orders to leave. State Attorney Dave Aronberg found the shooting justified.
But, Kaplan argued in court papers, the evidence disputes McGehee’s account. The bullets were fired toward the house, he said. Alvarez, who was diagnosed with schizophrenia shortly after graduating from high school, was just trying to welcome a new neighbor, he said.
Editor’s Note: Because of incomplete information provided by attorney Stuart Kaplan an earlier version of this story said the Palm Beach County Sheriff’s Office was paying the full $600,000 settlement.
In what could be a harbinger of a particularly contentious judicial election season, the Palm Beach County Bar Association has already logged its first ethics complaint against a candidate.
“We’ve never had a complaint filed this early before,” bar association CEO Patience Burns said of the complaint filed last week against county court judge candidate Lisa Grossman. “We’re not prepared to accept it.”
The Judicial Campaign Practices Commission, which reviews complaints of unethical behavior and issues advisory opinions, won’t be formed until after the election qualifying period ends at noon on May 6, Burns said.
That means the complaint, accusing Grossman of improperly converting her personal Facebook page into a campaign advertisement and dragging her nearly 300 “friends” along for an unplanned political ride, will be put on hold, she said.
Attorney Alka Sharma, co-chair of the campaign committee for incumbent Judge Marni Bryson, said several people called her upset that Grossman was using their Facebook friendship to shore up her judicial campaign. Some of those “friends” are supporting Bryson in the Aug. 30 election, she said.
The page titled, “Lisa Grossman for Judge,” shows pictures of people holding Grossman campaign signs. Before the March 15 presidential primary, the North Palm Beach lawyer posted this: “Anyone interested in holding a sign at an early voting site between 10-6 this weekend please contact me!!”
Sharma said her research showed that the converting a personal Facebook page into one for a campaign is improper under rules that dictate what is and isn’t allowed in Florida judicial races. While such sites can be created by an election committee, they can’t be established or maintained by the candidate themselves, she wrote in the complaint. Even then, she said, the committees can’t control who counts themselves among the candidates’ supporters.
The rules for judicial candidates differ wildly from those seeking other offices. Grossman should bone up on them, Sharma said. “She seems to be kind of doing it Wild West style,” she said.
Gross declined comment. “At this point it’s all unsubstantiated hearsay,” she said.
A Palm Beach County woman has sued Wellington Regional Medical Center, claiming a hospital worker flushed her baby down a toilet after she suffered a miscarriage in the emergency room bathroom two years ago.
In the lawsuit filed last week in Palm Beach County Circuit Court, Linda Gomez said she watched in horror as her baby, born more than four months premature, disappeared. She “could readily see the face of (the) child as it was flushed down the toilet … creating an image that (she) cannot forget,” according to the lawsuit filed by Tampa attorney Kennan Dandar.
Hospital officials weren’t immediately available for comment.
In addition to losing her child after 19 weeks of pregnancy in July 2014, Gomez claims hospital officials refused to retrieve the child so she could give the baby a burial “in accordance with her Christian faith.”
“The conduct of the (hospital) and its employee was outrageous, that is, as to go beyond all bounds of decency, and to be regarded as odious and utterly intolerable in a civilized community,” Dandar wrote.
He is seeking an unspecified amount in damages for Gomez for the emotional trauma she endured.
She had gone to the hospital because she was experiencing bleeding. When she went to the bathroom while waiting to see a doctor, she had the miscarriage. Unable to summon help, she cut the umbilical cord herself, Dandar wrote. The unidentified hospital worker heard her screams, flushed the toilet and told Gomez to return to the waiting room, he said in the lawsuit.
With one glaring exception, a federal judge on Thursday cleared the Palm Beach County Sheriff’s Office of allegations that it intentional destroyed or hid evidence to thwart a multi-million lawsuit filed by the parents of Seth Adams, who was shot and killed by Sgt. Michael Custer four years ago.
While attributing most of the agency’s lapses to negligence or technological glitches, U.S. District Judge Daniel Hurley said he was still “deeply concerned” that it allowed Custer’s cellphone to disappear.
“I’m disturbed that it was treated so carelessly as it came down the line,” Hurley said at the conclusion of an all-day hearing that included testimony about why the sheriff’s office destroyed Custer’s laptop, didn’t promptly provide emails that were exchanged about the shooting and waited months before revealing the GPS locations of Custer and five other officers who were nearby on the night of the May 2012 shooting.
Before deciding whether the phone’s disappearance warranted sanctions against the agency, Hurley said he wanted to do additional research. He said he was torn between whether the agency acted in bad faith or was “extraordinarily negligent.” He promised to issue a written order soon.
Adams’ parents, who sat in the courtroom throughout the roughly eight-hour hearing, were clearly distressed by Hurley’s rulings. But, their attorney, Wallace McCall, described them as bumps in an already pot-filled road, not fatal blows.
“The important thing is nothing he ruled on today will effect the outcome of this case,” he said. “Michael Custer unjustifiably shot and killed Seth Adams.”
He said he expects a jury will agree when it hears the evidence at a trial he expects to be held next year.
Attorneys for the sheriff’s office declined comment.
The debate often turned on technical computer terms and legal considerations that U.S. District Judge Daniel Hurley must weigh while considering whether the agency should be sanctioned. For instance, PBSO attorneys claim all of the information on Custer’s laptop was stored on servers at the agency so it doesn’t matter that the hard drive was shredded when he was due for an upgrade. Further, they claim, attorneys representing Adams’ family in the multi-million-dollar wrongful death case didn’t ask for the laptop until after it had been destroyed.
Still, even Hurley acknowledged that having the information on the laptop would help attorney Wallace McCall, who is representing Adams’ family, sort out what happened in May 2012 when Custer shot the 24-year-old Loxahatchee Groves resident as he was returning to his family’s garden shop on A Road, off Okeechobee Boulevard, where he also lived. All agreed that there could be some information that wasn’t saved on PBSO servers.
“We can all see there might have been a benefit in saving the hard drive,” Hurley said.
The laptop and Custer’s cellphone are among several items McCall claims the agency intentionally destroyed to thwart the lawsuit. He also claims the agency initially claimed it couldn’t give him GPS information that would show where Custer and six other officers were on the night of the shooting.
Attorney Summer Barranco, who represents the sheriff’s office and Custer, attributed the failure to a simple mistake. Instead of searching agency computer records for GPS readings on May 16, 2012, it searched May 16, 2014. When the error was discovered, the information for most of the officers was provided. For some reason, no information was available to pinpoint Custer’s location.
Hurley suggested the agency may have to pay McCall for the time he wasted, trying to get the information that was readily available but for the gaffe. He suggested that the attorneys negotiate a reasonable amount.
While U.S. District Judge Daniel Hurley called the agency’s actions “deplorable” at a previous hearing, he said he wanted to hear additional testimony before deciding what action, if any, to take.
If he finds the destruction of Sgt. Michael Custer’s laptop and the disappearance of his cellphone particularly egregious, he could decide the case in favor of Adams’ grieving family. Then, a jury would be asked only to decide how much money the family deserves to be compensated for Adams’ death.
However, Hurley could decide to fine the agency or take other steps to remedy the loss of evidence he acknowledged could have provided key information about why Custer fatally shot Adams as he was returning to his family’s garden shop on A Road, off Okeechobee Boulevard, where he also lived.
Custer claims he shot Adams, fearing he was reaching into his pickup truck for a gun. Instead, the unarmed Adams was grabbing his cell phone.
At the last hearing in November, attorney Wallace McCall, who represents Adams’ family in what is expected to be a multi-million lawsuit, showed Hurley emails in which a deputy indicated that the disappearance of the cellphone was part of “an evil plan.”
However, the lieutenant who received the email testified the “evil plan” had nothing to do with the cellphone. Custer claims he turned it over to the agency’s communications unit as he was told to do so by higher ups. It was never logged in.
Sheriff’s officials speculate that because it was an older model, workers mistakenly gave it to the Domestic Violence Unit. It gives old phones to battered women to use in emergencies.
The laptop, meanwhile, was also an older model, sheriff’s officials have said. It was destroyed as part of a routine practice when deputies are given upgraded computers.
The hearing is expected to last all day.
Hurley has already ruled that the sheriff’s office can’t be sued for violating Adams’ constitutional rights but Custer can be. Custer last month appealed that ruling to the 11th Circuit Court of Appeals.
If the Atlanta-based court upholds Hurley’s ruling, Adams’ family would be in the same situation as Dontrell Stephens. The 22-year-old West Palm Beach man was awarded $22.4 million last month by a federal jury. It ruled that Deputy Adams Lin in 2013 had no reason to shoot Stephens, leaving him paralyzed from the waist down.
State law places a $200,000 limit on the amount of damages government agencies can be forced to pay for wrongdoing. The only way Stephens can get the full amount is to persuade the Florida Legislature to waive the cap. The caps, however, don’t protect a government agency if it is found to have violated someone’s constitutional rights.
In court papers filed Tuesday in Palm Beach County Circuit Court, the World Golf Hall of Fame member sued his longtime corporate lawyer Jack Schneider, claiming the attorney stole trade secrets before he was fired on Feb. 8.
Norman, who named his diverse West Palm Beach-based company, Great White Shark Enterprises, after the nickname he earned for his tenacity on the links, is seeking an injunction against Schneider to prevent him from using any of the information.
In addition to “copying and deleting proprietary, confidential and trade secret information,” Schneider damaged company computer equipment when removing the hard drives, according to the lawsuit filed by Boca Raton attorney Erika Deutsch Rotbart.
Schneider, who lives in suburban Lake Worth, wasn’t immediately available for comment. After working for Norman’s company for 14 years as both its general counsel and chief financial officer, he was fired for “blatant disregard of his duties to (Great White Shark Enterprises), insubordination … among other gross failures,” according to the lawsuit.
Formed more than 20 years ago, Great White Shark Enterprises includes golf course design, event management, apparel, wine and, most recently, asset-based debt lending.