Medicare fraud or ‘honest mistakes’? Eye doctor Melgen’s trial begins
This is how Brockman ended up in the care of Dr.
A federal prosecutor said Thursday he was just one of many seniors -- some poor minorities -- who were pawns in the doctor's scheme to defraud the federal medical insurance program for the elderly and disabled. It was the opening shot by the government in Melgen's
Assistant
Invasive procedures
The prosecutor said the government culled about 30 cases from 2008-13 as a sample of Melgen's practice and found incidents of patients diagnosed with macular degeneration who did not have the disease. Almost every one of his patients underwent repeated invasive procedures -- injections and laser treatment.
"This highly trained,
And while Melgen could have used a "state-of-the-art" machine to diagnose macular degeneration, such a painless procedure would have resulted in only a
Melgen's attorney, though, told jurors that prosecutors cherry-picked honest billing mistakes in order to paint them as fraudulent. He said even the government's own experts disagree when looking at Melgen's patient files, saying this area of medicine is often more art than science.
"Doctors don't become doctors to become scribes," Melgen's defense attorney,
Melgen's attorneys have said in court documents that the FBI used a criminal investigation into the doctor's practice to cull material for the bribery case. Menchel didn't mention the Menendez bribery scandal to the jury but he again targeted the FBI, saying agents manipulated the doctor's patients to turn against him and change their stories.
Loved physician?
"Many of
The government will call former patients and employees to testify against the doctor. The first patient to testify laid the foundation for Melgen charging
Menchel said some of the patients who will testify are not credible, such as one who is expected to say that Melgen treated his prosthetic eye with a laser. The attorney said it was preposterous that a
He said many of the government's own witnesses will admit their eyesight got better under the doctor's care. As for filling out paperwork or the diagnosis before seeing a patient, the attorney said that was pro forma for most busy medical practices to move along information for the next appointment and that Melgen's use of dyes for diagnostic tests was the gold standard -- not some machine as promoted by the prosecution.
Menchel told the jury that he found it interesting that in such a big scheme to defraud that not one of the doctor's former staffers had been charged with fraud. "There will not be a shred of evidence that he told technicians or staff to commit fraud," the attorney said.
The trial is expected to take several weeks.
Bribery scandal
Melgen also faces 13 additional charges in a separate case in connection with allegedly showering gifts upon Menendez in exchange for helping the physician in a billing dispute with the
Menendez has tried to have his corruption case thrown out, unsuccessfully so far, but promises to appeal to
Menendez used his pull to influence
The quid pro quo, prosecutors say, was that Menendez received gifts from his friend worth close to
Melgen also contributed
As previewed by the opening statements, a good portion of the trial will center on Melgen's use of the pricey eye drug called Lucentis, using single-dose vials on multiple patients and then separately billing
The doctor claimed in court documents that the government doesn't explicitly prohibit multi-dosing of Lucentis and that the government would have ended up paying full price for each dose anyway. His lawyers also accuse the government of overcharging the doctor with corresponding statutes for the same allegation -- an issue that won't be addressed until the later in the trial.
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