(Florida) Doctor With Big Medicare Billings Is No Stranger to Scrutiny (NJ Sen Menendez' donor/pal)

NY TIMES ^

[Liz]

The South Fla doctor who billed Medicare for $21 million in 2012 alone, is a generous political donor to NJ Sen Robert Menendez, now under investigation by federal public corruption prosecutors. The millionaire surgeon, lives luxuriously in North Palm Beach, Fla, and travels by private jet, to his luxe villa in the Dominican Republic.

Menendez took free rides on the doctor’s private jet and stayed at his luxury resort villa in the Dominican Republic. The senator was forced to pay back the cost of the travel under scrutiny. Melgen donated over $700,000 to Menendez's PAC......Menendez made calls on the Melgen’s behalf to HHS when Melgen was beset with overbilling allegations.

Menendez advocated on behalf of the doctor during a special Senate hearing into a port security contract in the Dominican Republic. The hearing involved a port security company that Dr. Melgen had purchased in the hopes that the Dominican Republic would start screening every container on every outbound vessel. The Customs agency refused to honor the contract; Sen Menendez urged US officials to get involved. Without mentioning his friend, the senator used his powerful position to urge federal agencies not to donate free port equipment that would have competed with the doctor’s business plans.

Dr. Melgen and his family in the Dominican Republic are powerful members of the political establishment. Dr. Melgen co-founded Voxxi, a Hispanic-oriented news site, which has published laudatory articles about the doctor and the Senator.

[Uncle Chip]

Melgen’s lawyers assert he did not bill Medicare fraudulently. They contend the doctor differed with the program over its reimbursement policy for Lucentis.

Medicare reimburses $2,000 for each vial of the drug used to treat macular degeneration. The policy is that one vial is used for each patient. But Melgen is suspected of using one vial for as many as four patients, while submitting claims of up to $8,000, as if he had used separate vials for each, according to sources familiar with the billing dispute.

In a 2012 report by the Health and Human Services’ inspector general, the agency recommended that Medicare officials stop using the drug because it was so costly, noting there was a cheaper and equally effective alternative called Avastin. In 2010, Medicare approved $1.1 billion in reimbursements for Lucentis, a drug manufactured by Genentech.

http://www.miamiherald.com/2013/02/07/3222772/so-fla-eye-surgeon-under-scrutiny.html