Medicare Pays Millionaire Linked to Senate Scandals More than Any Other Doctor
A scandal-scarred multimillionaire Democratic Party donor was paid more by Medicare than any other doctor in the nation in 2012, according to new data released by the Obama administration.
Dr. Salomon Melgen, a South Florida ophthalmologist at the center of the scandal implicating Sen. Bob Menendez (D-NJ), received $21 million in Medicare reimbursements that year, the data show.
“Data released Wednesday by the Centers for Medicare and Medicaid Services shows that Dr. Salomon E. Melgen, 59, who moved to Florida from the Dominican Republic in the late 1970s, received $21 million in Medicare reimbursements in 2012 alone,” the New York Times’ Frances Robles wrote. “The doctor billed mostly for Lucentis, a medication used to treat macular degeneration made by a company that pays generous rebates to its doctors.”
Melgen’s relationship with the Department of Health and Human Services (HHS)--particularly the Center for Medicare and Medicaid Services (CMS)--is a central part of the scandal stemming from Sen. Menendez’s allegedly improper activities on Melgen’s behalf. Menendez reportedly met with senior HHS and CMS officials, including the CMS director Jonathan Blum, to intervene on Melgen’s behalf in a billing dispute between Melgen and HHS.
According to the Washington Post, Melgen broke vials of medication that fights macular degeneration into 3-4 doses, then charged Medicare anywhere $6,000 to $8,000 per vial—charging for Medicare for each dosage rather than by vial—when they are actually are supposed to be billed at about $2,000 per vial. Melgen has not denied doing so, but has defended the practice arguing it is within the bounds of the law.
Melgen’s billing practices sparked an HHS Inspector General investigation, and one former HHS investigator told the Washington Post that Melgen “thought he was untouchable” during an interview during which he kept referencing Sen. Menendez as “a character reference.”
Melgen’s attorney Kirk Ogrosky released a statement Tuesday evening saying the high Medicare billing statistics for his client are not an indication of wrongdoing. “At all times, Dr. Melgen billed in conformity with Medicare rules,” Ogrosky said. “While the amounts in the CMS data release appear large, the vast majority reflect the cost of drugs. The facts are that doctors receive 6 percent above what they pay for drugs, the amount billed by physicians is set by law, and drug companies set the price of drugs, not doctors.”
Nonetheless, in its Wednesday story, the Times noted that this latest disclosure from HHS that he was the most-paid doctor from Medicare is “the latest in a series headline-grabbing disclosures that have dogged the doctor since January of last year.”
“The millionaire surgeon, who lives in a 5,000-square-foot home in North Palm Beach and travels by private jet, is better known as the generous campaign contributor whose close relationship with Mr. Menendez, a Democrat, has been scrutinized by federal prosecutors,” the Times wrote.
The Melgen records, the Times wrote, show “Melgen gave 37,000 units of Lucentis, also known as Ranbizumab, to 645 different patients. Overall, he had 894 patients who underwent 92,000 procedures.”
Melgen’s private jet is a central plank in this scandal. Menendez originally denied wrongdoing with regard to the flights, but two years later—in early 2013—decided to, under public scrutiny, reimburse Melgen for 2010 flights aboard his plane to the Dominican Republic.
That $58,500 reimbursement, according to the National Journal, cost Menendez 87 percent of his entire personal wealth to pay back. Menendez has only admitted to taking three flights aboard Melgen’s plane, but flight path data—and an eyewitness account from a local New Jersey resident who saw Menendez with Melgen in a diner near Teterboro airport—suggest Menendez took a fourth flight to the Dominican Republic aboard Melgen’s plane around Easter-time 2012.
Menendez’s friend and Melgen’s cousin Vinicio Castillo Seman, a Dominican lawyer and politician, also confirmed Menendez was in the Dominican Republic at that time. “We spend every Easter together in Casa de Campo [the posh resort Melgen parties at],” he said in February 2013, according to a local news outlet.
Menendez has refused to publicly release travel records, and declined to answer questions from Breitbart News at an Amtrak station in Newark in March 2013.
These details only account for part of the wide-reaching Menendez influence-peddling scandal, and another major focus of the scandal is how Menendez—according to the New York Times—used a congressional hearing to further Melgen’s business interests in the Dominican Republic. Menendez pressured the State Department during a 2012 hearing of a Senate Foreign Relations Committee subcommittee he chaired to “send a message” to the Dominican government for not supporting the finalization of a business deal that would have given Melgen control over a major port’s security contract making him millions of dollars.
The scandal has sparked an FBI investigation, an HHS Inspector General investigation and federal grand jury investigation that each remain open and ongoing. The Senate Ethics Committee is probing Menendez as well, and the senator has paid a top Washington lawyer thousands of dollars according to Federal Election Commission (FEC) record. The FEC records show that Menendez has paid Brand Law Group, PC, $2,220 on July 18. The disclosure was not made until October, when FEC filings for the third quarter were due. The expenditure was paid for by his campaign committee, Menendez for Senate.
Federal agents have twice raided the Melgen’s offices in South Florida, in January and in October 2013.
Neither Menendez nor Melgen have suffered any official punishment for these actions, despite the ongoing investigations. Nonetheless, as now Secretary of State John Kerry left the U.S. Senate, Majority Leader Harry Reid rewarded Menendez with the chairmanship of the powerful Senate Foreign Relations Committee as this scandal raged in the headlines. The New York Times’ editorial board called on Reid to remove Menendez from the chairmanship at least until the investigation concluded, something Reid refused to do.
While Reid originally vocally defended Menendez by bashing conservative media who broke the stories about the scandal and FBI emails proving an investigation when asked about it by Breitbart News, he backed down as soon as federal agents raided Melgen’s offices in January 2013. “I have confidence he did nothing wrong,” Reid said after the raid. “But that’s what investigations are all about.”