A federal criminal investigation into a West Palm Beach eye surgeon with close ties to a U.S. senator centers on the doctor’s billing of Medicare for millions of dollars to treat elderly patients suffering vision loss who may not have needed the costly services he administered, The Miami Herald has learned.
For the past year, federal agents have been investigating the medical practice of Dr. Salomon Melgen, who sources familiar with the inquiry say is suspected of overbilling the taxpayer-funded program through frequent use of a high-priced drug called Lucentis, which is injected into patients’ eyes.
Several sources familiar with the doctor’s practice said he used the drug, which costs $2,000 a vial, to treat patients with macular degeneration more than any other ophthalmologist in Florida and possibly the country. His high patient volume also raised red flags for investigators, the sources said.
Under Medicare policies, a doctor may only prescribe treatment that is “reasonable” and “necessary.” To make a case, federal prosecutors would have to prove that Melgen needlessly treated patients simply to run up sky-high Medicare bills.