Eye doc Melgen guilty in one of nation’s biggest Medicare fraud cases

Chalking up one of the biggest health-care fraud convictions in the nation, a federal jury on Friday convicted Palm Beach County retinal specialist Dr. Salomon Melgen of 67 charges for operating what prosecutors called a massive scheme that robbed Medicare out of as much as $105 million.

The 62-year-old physician, who lives in a multi-million-dollar house along the Intracoastal Waterway near Juno Beach, showed no emotion as the word “guilty” rang out dozens of time in the wood-paneled courtroom. He was equally stoic when federal marshals snapped handcuffs on his wrists to take him to jail where he will await sentencing on July 14.

U.S. District Judge Kenneth Marra denied a request from Melgen’s attorneys to allow the ophthalmologist to remain free on an $18 million bond package. While Melgen sold his jet and boat, Marra said he wasn’t convinced the wealthy doctor, who was born in the Dominican Republic and still owns property there, wouldn’t flee.

Having been convicted of crimes that could send him to prison for as long as 20 years, Melgen also faces a Sept. 6 trial on corruption charges in New Jersey with U.S. Sen. Robert Menendez, D-N.J. Through his lawyer, the political heavyweight issued a statement saying “he is saddened for his long-time friend and is thinking of his family on this difficult day.”

While much of national attention has been focused on the looming corruption trial, the health-care fraud case has been watched closely in the medical community, said Dr. Robert Bergen, a retired New Jersey retinal specialist who now lives in Boca Raton.

“Everybody knew about this guy,” said Bergen, who was hired by prosecutors to review the charts of 310 of Melgen’s patients and testified that Melgen’s methods were “totally disgraceful.”

Bergen he said his heart went out to Melgen’s family. But, he said, the 12 jurors reached the right decision after deliberating for nearly 20 hours during three days at the conclusion of a two-month-long trial.

“It had to be done,” Bergen said of the verdict. “It’s the most egregious example of totally taking advantage of patients, not caring about diagnosing them properly, not caring about treating them properly. It was the antithesis of what a decent physician should do.”

After comforting Melgen’s wife, daughter and other family members, Melgen’s attorneys, Kirk Ogrosky and Matthew Menchel, vowed to appeal.

“We’re terribly disappointed,” Ogrosky said. “He cares very deeply about his patients and he tried very hard to help them.”

Having endured years of investigations, Melgen steeled himself for the verdict. “He’s an adult and he understands what’s happening even though he doesn’t agree with it,” Ogrosky said.

Flor Melgen, who stood by her husband of roughly 40 years, decried the jury’s decision. “It’s unfair. It’s unfair,” she said as tears welled up in her eyes. “He’s a good doctor.”

But, the evidence was overwhelming. Bergen along with two of the nation’s top retinal specialist testified that Melgen used antiquated tests, which were poorly done, to diagnose patients with wet macular degeneration — a sight-robbing eye disease that the experts said most of Melgen’s patients didn’t have.

He billed Medicare for hundreds of unreadable tests he conducted on patients who had prosthetic, blind or shrunken eyes, said Assistant U.S. Attorneys Roger Stefin, Alexandra Chase and Carolyn Bell, who prosecuted the complex case.

The most riveting testimony came from Dr. Julia Haller, ophthalmologist in chief at Wills Eye Hospital in Philadelphia. Testifying for three days, she called Melgen’s practices “abusive,” “unconscionable” and “horrifying.” She said it made her “embarrassed for our entire profession.”

Her testimony spurred Melgen’s attorneys on Monday to file a motion for a mistrial. They called her testimony “intentionally inflammatory” and improper. Marra has yet to rule on the request.

Ogrosky also pointed out that testimony from the prosecution’s medical experts was contradicted by Melgen’s patients and staff, who described Melgen as a good doctor who helped people.

There are many issues that will be litigated before Melgen is sentenced. A key to determining how much time he will serve is how much he stole from Medicare.

Prosecutors are expected to stick by claims that he bilked Medicare out of as much as $105 million. His attorneys, meanwhile, are expected to claim he is only on the hook for the bills linked to the 30 patients who were part of the 76 count indictment. Marra tossed out nine of the 76 charges before the case was sent to the jury.

Ogrosky said Melgen’s conviction will have no impact on his upcoming trial in New Jersey. He and Menchel represent him in that case as well. In a statement, attorney Abbe Lowell, who represents Menendez, agreed with Ogrosky’s assessment.

“Dr. Melgen’s case focused solely on the day-to-day operations of his medical practice and the private care of his patients — specifics of which the senator could not be aware, nor has it ever been suggested otherwise,” Lowell wrote.

He predicted Menendez would be cleared of allegations that he accepted campaign contributions and free trips from Melgen in exchange for helping him with various disputes, including ongoing ones with federal health regulators, and helping the doctor bring mistresses into the country from overseas.

Like others who watched the trial unfold, Bergen said the case was a sad one. Melgen trained under a renowned ophthalmologist at Harvard. He was clearly gifted, yet lost his way. “It’s sad that a physician could stoop so low,” Bergen said.

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