Salomon E. Melgen, Medicare Fraud, Florida 2023

South Florida Doctor Charged in Medicare Fraud Scheme

A South Florida doctor has been charged with participating in a massive Medicare fraud scheme, announced U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida. Salomon E. Melgen, 60, of North Palm Beach, Florida, was charged in a 76-count indictment with 46 counts of health care fraud, 19 counts of making, presenting and filing false, fictitious and fraudulent claims and 11 counts of making false statements relating to health care.

Melgen, an ophthalmologist and retina specialist licensed to practice medicine in the state of Florida, owned and operated Vitreo-Retinal Consultants of the Palm Beaches (VRC), a medical clinic with four offices in Palm Beach and St. Lucie Counties. Melgen's high-volume medical practice provided services to as many as 100 patients or more in a single day, with a large percentage of his patients being Medicare beneficiaries.

The indictment alleges that from as early as 2004 and continuing through at least Dec. 31, 2013, Melgen participated in a scheme to defraud Medicare and other health care benefit programs by submitting false claims and creating fraudulent entries on patients' medical charts. Melgen is alleged to have falsely diagnosed patients with serious eye conditions, notably age-related macular degeneration (ARMD or AMD) and retinal disorders.

According to the indictment, Melgen would perform and bill for medically unreasonable and unnecessary tests and procedures, including unnecessary laser surgeries and eye injections. The defendant is also alleged to have made exorbitant and improper profits from the purchase and administration of the drug Lucentis, which is used for the treatment of wet macular degeneration.

The indictment further charges that, between January 2008 and December 2013, the defendant billed the Medicare program more than $190 million, for which he, through VRC, was reimbursed and paid more than $105 million. A substantial portion of these reimbursements were allegedly obtained through fraudulent means.

The case is being prosecuted by the U.S. Attorney's Office for the Southern District of Florida and is being investigated by the FBI's Miami Field Office, the U.S. Department of Health and Human Services Office of the Inspector General's Miami Region, the U.S. Railroad Retirement Board's Office of Inspector General, and the Defense Criminal Investigative Service.

Source: https://www.justice.gov/archives/opa/pr/south-florida-doctor-indicted-medicare-fraud