According to Ogrosky, Dr. Melgen uses Avastin along with Lucentis. He says the cheaper drug isn’t in the breakdown of payments because Avastin is not labeled to treat macular degeneration. Ogrosky says he assumes Melgen included the cost of the drug in another category when reporting the charges to Medicare. Such use of the drug is not illegal, nor is it prohibited by the FDA.
Last year, federal agents raided Melgen’s West Palm Beach office when regulators discovered he was using one vial of Lucentis to treat several patients. Medicare rules permit only one vial per patient. Melgen repaid the government $9 million.
That wasn’t the end of the matter, however. Melgen then sued the Department of Health and Human Services, claiming that he had not overbilled and, perhaps more importantly, did not hide from Medicare the fact that he had treated multiple patients with one vial.
His lawsuit is still pending, and for a time HHS suspended all Medicare payments to Melgen’s practice. But that suspension has since been reversed.
Melgen owns a private jet, a residence in a West Palm Beach gated community, and a house in the Dominican Republic.
He is also a regular contributor to Menendez and the Democratic party. Although he is not Menendez’s top donor, Melgen and his family members have donated $33,700 to Menendez since 1992, according to OpenSecrets.org. They donated another $60,400 to the Democratic Senatorial Campaign Committee, which Menendez chaired from 2009 to 2011.
The senator also flew to the Dominican Republic on the doctor’s private jet and stayed at Melgen’s home there. The Senate Ethics Committee forced Menendez to pay $58,000 in reimbursements.
The Melgens also donated another $63,000 to the Democratic National Committee.
Multiple calls to Senator Menendez’s office went to a voicemail saying all lines were busy.
According to the Miami Herald, Menendez has in turn been a good friend to the high-rolling doctor:
In 2009 and again in 2012, Menendez complained to top Medicare officials that it was unfair to penalize the doctor because the billing rules for administering Lucentis were ambiguous, the senator’s aides told the Washington Post after it broke the story in February.
When Melgen, who has invested in a variety of businesses outside his medical practice, needed help with a port security contract in the Dominican Republic last year, he turned to Menendez. The senator tried to get the State Department to revive the long-stalled, multimillion-dollar agreement at the Santo Domingo port with a company of which Melgen is part-owner.
Menendez’s official actions on behalf of his longtime friend came to light after federal agents raided Melgen’s clinic and two other South Florida offices in late January, which sent shockwaves from the Dominican Republic to New Jersey to Washington. Published reports noted that the doctor had donated more than $700,000 in 2012 to Menendez’s reelection campaign and those of other Senate Democrats.
Politicians aren’t the only ones receiving cash from Melgen. He also has quite an investment portfolio.