Both were prominent members of their communities—the Florida doctor and the New Jersey U.S. Senator.
The doctor most assuredly and the senator more than likely will soon be inmates in the Federal Bureau of Prisons.
Earlier this month, Dr. Salomon Melgen, a well-respected Florida phthalmologist, was convicted on 67 counts of healthcare-related fraud. He now faces up to 15 to 20 years in a federal prison. Federal prosecutors proved that Dr. Melgen between 2008 and 2013 made more than $100 million through his fraudulent schemes; namely, submitting false Medicare claims, falsifying patients’ files, and making unnecessary diagnoses that laser treatments for patients who did not need them.
In the late 1990s, Dr. Melgen became active in Democratic politics, using his 6500 sq. ft. North Palm Beach home for fund raising benefits and other political gatherings. It was during one of these gatherings that Dr. Melgen met New Jersey’s powerful Democratic U.S. Senator Bob Menendez. Their casual acquaintance evolved into what federal prosecutors believe was a partnership in crime.
In exchange for the senator’s alleged influence peddling, federal prosecutors say Melgen was a consistent campaign donor to Menendez; and that he took the senator on exquisite trips to France and the doctor native Dominican Republic. Menendez reimbursed the doctor a total of $58,000 once the trips were disclosed by the media.
Menendez is currently facing federal corruption charges, and Melgen faces additional charges for allegedly bribing the Senator. While Menendez has told reporters that Melgen’s conviction will have no impact on his upcoming trial, that’s not at all certain. Federal prosecutors will use Melgen’s current convictions to pressure him into testifying against Menendez in exchange for sentencing leniency.
The ultimate fate of the two men will not be known for months, but the case is certainly one to keep an eye on.
Why are health care fraud penalties so severe?
The Costs of Health Care Fraud (Arguably) Justify the Consequences
Health care experts estimate that medical fraud costs taxpayers $68 billion each year. That is 3% of health care spending overall. Other estimates say that fraud accounts for up to 10% of overall healthcare spending.
Because of this, federal lawmakers take health care fraud very seriously and want to do everything possible to crack down on it. The war on healthcare fraud got even more serious once the Patient Protection and Affordable Care Act was passed due to the fact that the government is now more involved in how we get healthcare than ever before.
Legislators at both the state and federal level are constantly looking for new bills to tackle different health care fraud schemes and account for all of the different ways that people try to cheat the system. This, however, is something that is incredibly complicated. People throughout the entire health care system have been known to engage in health care fraud: patients, doctors, and healthcare providers.
Because of this, lawmakers cast a wide net and in many cases define fraud very broadly. The result for people who are accused is that there are all kinds of acts you could potentially engage end that might lead to your spending years in prison and facing exorbitant fines.
If you have been arrested or charged with health care fraud, your best hope for a positive outcome is to start fighting back. There are a number of options you can use to defend yourself against these charges, but many of them may not apply to your specific situation. Learn what’s best for you by getting in touch with a federal health care fraud lawyer immediately.