South Florida Doctor Sentenced in Medicare Fraud Scheme
Dr. Salomon Melgen was sentenced today to 17 years in prison, to be followed by three years of supervised release by the U.S. District Judge Kenneth A. Marra in West Palm Beach, Florida. This sentencing is the culmination of a multi-year investigation, which was followed by an eight week jury trial in April 2017 that resulted in Melgen’s conviction on 67 counts of health care fraud and related charges.
Benjamin G. Greenberg, United States Attorney for the Southern District of Florida; Robert F. Lasky, Special Agent in Charge, Federal Bureau of Investigations (FBI), Miami Field Office; Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG); Patrick Fletcher, Special Agent in Charge, U.S. Railroad Retirement Board, Office of Inspector General (RRB-OIG); and John F. Khin, Special Agent in Charge, Defense Criminal Investigative Service (DCIS), made the announcement.
Melgen, an ophthalmologist who specialized in the treatment of retinal disorders and who had practiced in Palm Beach and St. Lucie Counties for many years until his arrest in 2015, engaged in a scheme to defraud the Medicare program and other health care benefit programs, by, among other things, falsely diagnosing Medicare patients with macular degeneration and then performing and billing for excessive and medically unnecessary tests and procedures, which included injections of expensive drugs and laser treatments. These tests and procedures resulted in Melgen’s receiving tens of millions of dollars in reimbursement from the Medicare program alone during the six-year period of January 2008 through December 2013.
In sentencing Melgen, Judge Marra found that the intended fraud loss was over $70 million and the actual fraud loss to Medicare was $42 million. In addition to the term of incarceration, the defendant was ordered to make full restitution to Medicare. Losses to other insurance companies and to individual patients will be determined at a future hearing.
“In perpetrating his multi-million fraud scheme on health care benefit programs like Medicare, Dr. Melgen showed complete disregard for what was best for his patients and abused their trust for his own personal financial gain,” stated U.S. Attorney Benjamin G. Greenberg. “Dr. Melgen has been held responsible for his egregious fraud scheme. Today’s sentence should serve as a reminder that the U.S. Attorney’s Office and our law enforcement partners remain committed to bringing those who illegally divert the community’s tax dollars to justice, regardless of their professional position.”
“The reprehensible conduct of Salomon Melgen is a disgrace to the medical profession,” said Robert F. Lasky, Special Agent in Charge, FBI Miami. “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. The FBI will not relent in its pursuit of Medicare fraudsters – including greedy doctors.”
“Salomon Melgen callously took advantage of patients who came to him fearing blindness,” said Shimon Richmond, Special Agent in Charge of the U.S. DHHS Office of Inspector General’s Miami Region. “Instead of treatment, they received medically unreasonable and unnecessary tests and procedures that victimized his patients and the American taxpayer. Today’s sentencing is a stark reminder that the OIG and our partners will not tolerate Medicare fraud and will not rest in our efforts to protect patients in their time of need.”
“The U.S. Railroad Retirement Board, Office of Inspector General is committed to fighting Medicare fraud, waste and abuse and is proud to be part of this collaborative effort with the FBI, HHS-OIG, DCIS-OIG and OPM-OIG,” said Inspector General Martin J. Dickman. “The sentencing of Dr. Melgen sends a loud and clear message that combating Medicare fraud is a top Federal law enforcement priority and unscrupulous Medicare providers will not be tolerated.”
“This sentencing demonstrates the effectiveness of our joint investigations to pursue corrupt health care providers who defraud Federal health care programs,” stated Defense Criminal Investigative Service (DCIS) Special Agent in Charge John F. Khin, Southeast Field Office. “DCIS is committed to preserving the integrity of DoD’s TRICARE program which serves America's Warfighters and their families.”
Mr. Greenberg commended the investigative efforts of the FBI, HHS-OIG, RRB-OIG and DCIS. This case was prosecuted by Assistant United States Attorneys Roger H. Stefin, Carolyn Bell and Alexandra Chase.