The friend of a U.S. senator and once the eye doctor of a Florida governor, Palm Beach County retinal specialist Dr. Salomon Melgen was sentenced to 17 years in prison on Thursday for bilking Medicare and other insurers out of as much as $73 million.
While the 63-year-old wealthy, politically-connected physician faced a possible 24½-year sentence, U.S. District Judge Kenneth Marra said a less severe punishment was justified given Melgen’s age and the unlikely chance he would commit future crimes.
He also ordered Melgen to pay $42.6 million in restitution to Medicare. Having called Melgen’s scheme one of the biggest Medicare fraud cases in the nation, federal prosecutors said they will return to court to ask Marra to tack on additional restitution for Melgen’s patients and other insurers.
Wearing blue prison scrubs, with his arms and legs shackled, Melgen showed no reaction to Marra’s decision. Attending the hearing were his wife, Flor; daughter, Melissa; and son-in-law, brother and parish priest. Roughly 20 other supporters stood outside because seats weren’t available in the small courtroom.
Kirk Ogrosky, one of Melgen’s attorneys, described Melgen’s family as “shell-shocked.”
The sentence satisfied neither prosecutors nor his attorneys, who also represented Melgen on influence-peddling charges in New Jersey with his longtime friend, U.S. Sen. Robert Menendez, D-N.J.
“Dr. Melgen continues to maintain his innocence,” Ogrosky told reporters outside the courthouse. “Hundreds of patients came forward and said he saved his vision when others couldn’t.”
Federal law enforcement officials offered a far different view of Melgen’s treatment of patients at his clinics in West Palm Beach, Wellington, Delray Beach and Port St. Lucie. He was convicted in April of 67 charges of health care fraud for falsely diagnosing and treating scores of elderly patients for wet macular degeneration to rake in millions of dollars.
“The reprehensible conduct of Salomon Melgen is a disgrace to the medical profession,” Robert Lasky, who heads up Miami’s FBI office, said in a statement. “Not satisfied with being a successful ophthalmologist committed to treating his patients’ legitimate medical conditions, Melgen devised a scheme to enrich himself by defrauding Medicare and other benefit programs to the tune of tens of millions of dollars.”
Indicted in April 2015, a week after he was charged with bribery in New Jersey with Menendez, there was widespread belief that Melgen was targeted so he would turn on his longtime friend. He never did, and both he and the powerful Democrat beat the corruption charges. A New Jersey jury deadlocked after a nearly three month trial in the fall and prosecutors late last month announced they would not retry the case.
In a statement, Menendez expressed sympathy for his “dear friend Sal” and his family.
“While I am not familiar with their legal options, I do know Sal has maintained his innocence and will continue to fight for justice in his case,” Menendez said.
Ogrosky vowed to appeal and voiced confidence that it would be successful. “We look forward to appearing before the 11th Circuit (Court of Appeals),” he said.
He asked Marra to release Melgen on bond while his appeal is pending. Marra said he would consider the request later.
Marra did agree to recommend that Melgen be held in a low-security prison and be treated for what Ogrosky described as an addiction to prescription drugs. Inmates can receive substantial gain time for successfully completing substance-abuse programs.
During the trial, some colleagues described Melgen as a gifted and aggressive doctor. Born in the Dominican Republic, Melgen was trained in Boston by a doctor who is considered the father of retinal surgery. In the late 1990s Melgen treated Gov. Lawton Chiles and began hosting Democratic fundraisers at his sprawling waterfront home near Juno Beach.
But he lost his way, prosecutors said. He started giving scores of elderly people injections in their eyes for a sight-robbing disease they didn’t have simply to bilk insurers, the prosecutors said.
Besides misdiagnosing and mistreating patients, Melgen beefed up his take with what prosecutors called the fraudulent practice of multi-dosing. Medicare officials and prosecutors say a drug that eye doctors use, Lucentis, is supposed to be administered at a rate of one $2,000 vial per patient, with any excess in the vial being disposed of. But Melgen would split a vial’s contents among three or four patients and charge Medicare $2,000 for each patient, prosecutors said.
Melgen’s lawyers argued it didn’t cost Medicare anything extra, since the agency’s policy was to pay for a vial per patient. But prosecutors said it was fraudulently lucrative for Melgen, who was reimbursed $6,000 or $8,000 for a vial that he paid only $2,000 for.
Even before the criminal trial, the practice spawned a lengthy legal battle with federal health regulators.
Meanwhile, in New Jersey, he was accused of giving Menendez trips and large campaign contributions in exchange for the senator’s assistance in that dispute, along with help in bringing Melgen’s foreign girlfriends into the country.
Pushing for a 30-year sentence, Assistant U.S. Attorney Roger Stefin told Marra that the 17-year sentence was too lenient. Shimon Richmond, head of the Miami office of the inspector general’s for the U.S. Department of Health and Human Services, blasted Melgen’s actions.
“Salomon Melgen callously took advantage of patients who came to him fearing blindness,” Richmond said in a statement. “Instead of treatment, they received medically unreasonable and unnecessary tests and procedures that victimized his patients and the American taxpayer.”