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Sen. Menendez contacted top
officials in friend’s Medicare dispute

Washington Post, by Carol D. Leonnig & Jerry Markon

Original Article

Posted By:Dreadnought, 2/6/2013 10:44:06 PM

Sen. Robert Menendez raised concerns with top federal health-care officials twice in recent years about their finding that a Florida eye doctor — a close friend and major campaign donor — had overbilled the government by $8.9 million for care at his clinic, Menendez aides said Wednesday. Menendez (D-N.J.) initially contacted federal officials in 2009 about the government’s audit of Salomon Melgen, complaining to the director overseeing Medicare payments that it was unfair to penalize the doctor because the billing rules were ambiguous, the aides said.

      


Post Reply  

Reply 1 - Posted by: texaspast, 2/6/2013 10:51:31 PM     (No. 9162787)

I´m not sure I have a problem with this. Medicare has been going postal on doctors, finding ´overbillings´ of enormous amounts based on little or no evidence, just needing to make an example of some doctor who hacks off the medicare people. Menendez is trash of the lowest sort, but this may be an example of him actually doing his job.

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Reply 2 - Posted by: Griz70, 2/6/2013 10:58:23 PM     (No. 9162792)

If this is true, $8.9 million is massive fraud. An ordinary taxpayer would go to jail for a few thousand dollars, but a large damocrap donor will walk.

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Reply 3 - Posted by: Rivetjoint, 2/6/2013 11:22:10 PM     (No. 9162811)

I wish Menendez took as great an interest in NJ beyond his obvious strong bias toward Hispanic issues. Any regular slob with only a small portion of Melgen´s IRS disputes would have been tossed in jail by now.

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Reply 4 - Posted by: enuf8, 2/6/2013 11:58:12 PM     (No. 9162837)

Hmmmmmm, overpayment of Medicare and 11 million owed the IRS. Melgon will skip out on his private plane----just watch.

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Reply 5 - Posted by: Th-Gr-Sil-Majority, 2/7/2013 1:16:17 AM     (No. 9162886)

...Florida, seniors, macular treatments and medicare, ripe for a flim flam man...


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Reply 6 - Posted by: Spidey, 2/7/2013 3:28:22 AM     (No. 9162934)

Wow, you wonder how an eye doctor got filthy rich and this is a perfect example.Racking up $9 million on overcharges to medicare alone.Then to have Melendez to intervene on a case of obvious fraud really take a lot of gall.

You really have to wonder how many other people in the medical profession are ripping off medicaid and medicare and soon the government will be in charge of all reimbursements.

You have other,honest doctors barely getting by on low medicare reimbursements while a crook like this accumulates millions in wealth.This should trigger a widespread investigation of crooks in the medical industry but it won´t.

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Reply 7 - Posted by: beamer, 2/7/2013 4:05:23 AM     (No. 9162949)

Democrats know how to scam the system. They would not exist if they were honest. In a private conversation with a top Chicago politician, he said politics is all money and sex. They get both. Lots of it! Wheeee!

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Reply 8 - Posted by: sorosisbehindit, 2/7/2013 7:08:17 AM     (No. 9163022)

Irrespective of his choir boy hair cut, this is one sleazy politician. New Jersey voters need to take out the trash!

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Reply 9 - Posted by: Starlady, 2/7/2013 7:22:10 AM     (No. 9163052)

THIS is the real issue IMO regarding Senator Menendez , not the prostitution. He is a politician bought and paid for by Melgren. It sounds like this eye doctor is just doing whatever treatments will bring in the highest dollar rather than what is most beneficial for his patients. He probably only treats low information voters.

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Reply 10 - Posted by: Grambo, 2/7/2013 7:46:55 AM     (No. 9163111)

The claim of ambiguity of the rules is accurate. Medicare has its own fraud rules, but they’re unenforceable. The defense puts federal Medicare officials on the stand and demonstrates that none of them can give the same answers, because the law is so massively complex and internally contradictory.

Instead, the Feds prosecute under a federal fraud act of 1865, signed into law during the civil war by President Lincoln. It has three elements to establish fraud: 1) you billed the government, 2) you did it more than once, and 3) more than one of your records were inaccurate or incomplete.

No organization can be innocent of fraud by those standards. The feds have been legally extorting money from health care providers with this law for years.


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Reply 11 - Posted by: Rinktum, 2/7/2013 8:18:23 AM     (No. 9163177)

The cavalier attitude regarding fraud and waste is directly due to the fact that it is not THEIR money. They believe it "comes from the big wealthy government who will never miss it" when it actually comes out of the pocket of the taxpayer. They are wealthy cheaters with an entitlement mentality. When there is little or no meaningful oversight and fraud protection, you will have people who game the system both rich and poor.

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Reply 12 - Posted by: DCGIRL, 2/7/2013 8:26:13 AM     (No. 9163192)

This senator is big time TRASH. But remember, so is Charlie Rangel, Maxine Waters, and Harry Reid. And all of them still have a job. So, makes you think that the Senate will have him removed. They all take care of themselves. Did any of you hear for his removal or resignation? I rest my case.

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Reply 13 - Posted by: roger h. cook,MD, 2/7/2013 10:12:34 AM     (No. 9163443)

To answer no.6´s question ; only if you have some one in high places in the democrat senate.

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Reply 14 - Posted by: lakerman1, 2/7/2013 10:12:38 AM     (No. 9163444)

Allow me to explain something.
Medical providers, when billing insurance companies and medicare, routinely ask for more money than will be paid by the insurer. That is how, over time, the provider boosts its reimbursement rates for procedures.
Dr. Melen was apparently doing something different, by claiming excessive procedures in a given time frame. That could be actionable.
Huge difference.

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Reply 15 - Posted by: pindarjr, 2/7/2013 10:20:43 AM     (No. 9163464)

My favorite Medicare fraudster story concerns a doctor in a large east coast city whose nickname was "Dr. Foot." In addition to massive medicare fraud, Foot had some rather nasty personal habits confirmed by at least three witnesses. He would use the same scalpel all day long on his mostly senior patients. And when he sometimes dropped his scalpel on the floor, his office workers would try, with only rare success, to persuade him to use a new one. (After all, scalpels are expensive.) But the story gets even better. When the AUSA was informed, he congratulated his investigators, stating that, "if the case ever went to trial, this info would have great jury appeal." No thought was given to passing the info on to any authorities governing physicians´ behavior based on the simple truth that such bodies are ever reluctant to get such info and to act on it. I don´t know whether this doctor is still operating or not, but, if your foot specialist´s license plate says, "DR FOOT," you should seriously consider finding another foot care provider.

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Reply 16 - Posted by: LZK, 2/7/2013 11:08:24 AM     (No. 9163563)

Ahhhhhhh -- so what WE have here is a Senator advocating for a good friend who is being "scrutinized" by the gooooberment?

Hmmmmmmmm -- doesn´t this sould like pay/back for all the campaign contributions the Senator took from this very doctor?????

AND flying -- FREE -- on the doctor´s private jet.....?????

Not to mention all those poooooor under/age GIRLS paid by the doctor -- who had to do the Senator....

LZK

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Reply 17 - Posted by: nevernaught, 2/7/2013 11:19:18 AM     (No. 9163584)

He is totally dirty and if he wasn´t a Democrat he would resign. I think that about covers the subject.

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Reply 18 - Posted by: stablemoney, 2/7/2013 12:11:31 PM     (No. 9163765)

$8.9 million is not a billing error. Every bill or claim would have had to have wrong for that amount of money from a physician. Medicare has billing codes for procedures performed and physicians know d--- well what they mean.

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Reply 19 - Posted by: Charactercounts, 2/7/2013 12:18:42 PM     (No. 9163786)

Agree with those who say the Doctor knew exactly what he was doing.

I have been to several local doctors, myself or with family members, who overbilled my insurance company while also charging me. When I questioned the charges to my insurance company´s integrity unit, the doctors all suddenly found "errors" in their billing, and re-filed the claims and refunded money to me, via a check in an envelope with no explanation.

As to Dr. Melgen, I´ve heard that the Clintons have also been recipients of his hospitality, staying at his home.

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Reply 20 - Posted by: globalwarmer, 2/7/2013 1:34:15 PM     (No. 9163999)

Gee, more fraud in government run programs? Hard to imagine!

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Reply 21 - Posted by: Penney, 2/7/2013 2:40:23 PM     (No. 9164111)

Corruption breeds corruption. The current beltway gang of statist pols seem to be saturated.

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Reply 22 - Posted by: Grambo, 2/7/2013 2:58:09 PM     (No. 9164132)

I am not a fan of this sleezeball, and don’t pretend to defend him, but some posters may not have grasped the significance of my post, #11, above.

A busy doctor’s office is submitting mountains of forms all the time. If a form has one box unchecked, it counts as Medicare fraud (incomplete record). Busy practices can generate hundreds or thousands of these over a few years. Each incomplete form is a count of fraud, with a penalty of thousands of dollars.

A Medicare audit finding hundreds or thousands of unchecked boxes can generate a total penalty of millions of dollars. Medicare then offers to settle for a small percentage of that, an offer the doctor can’t refuse. That money goes straight into the general fund, where it’s available for politician’s pork projects, so they encourage the Medicare IG to be aggressive.

In short, when Medicare claims they’ve turned up fraud, they may have, but on the other hand, they may just be shaking down a nice fat practice.

It’s what they do.


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Reply 23 - Posted by: civilservant, 2/7/2013 4:59:28 PM     (No. 9164390)

#24, #16 is a long time poster here, one whose comments show him to be a person of considerable knowledge.
I believe he covers the disparity between what you speak of, and what was committed.
A good night to all....

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Reply 24 - Posted by: Grambo, 2/7/2013 5:29:45 PM     (No. 9164428)

Agree, just revising and extending, with good will to all.

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