(NaturalNews) A pair of Florida physicians who were recipients of the country's highest Medicare reimbursements in 2012 are both major donors to Democratic Party causes, and they've turned to the political system in recent years in an attempt to defend themselves against suspicions that they may have submitted fraudulent or excessive claims with the federal government.
The New York Times reported that the pattern of whopping Medicare reimbursements and six-figure political donations has shown up among several doctors whose payment records were just recently released by the Department of Health and Human Services. For a number of years, the department would not make the data publicly available; it did so only after being sued by The Wall Street Journal.
As reported by the Times:
Topping the list is Dr. Salomon E. Melgen, 59, an ophthalmologist from North Palm Beach, Fla., who received $21 million in Medicare reimbursements in 2012 alone. The doctor billed a bulk of his reimbursements for Lucentis, a medication used to treat macular degeneration made by a company that pays generous rebates to its doctors.
Dr. Melgen's firm donated more than $700,000 to Majority PAC, a super PAC run by former aides to the Senate majority leader, Harry Reid, Democrat of Nevada. The super PAC then spent $600,000 to help re-elect Senator Robert Menendez, Democrat of New Jersey, who is a close friend of Dr. Melgen's. Last year, Mr. Menendez himself became a target of investigation after the senator intervened on behalf of Dr. Melgen with federal officials and took flights on his private jet.
Another doctor, Asad Qamar, who is an interventional cardiologist in Ocala, has sent at least a quarter of a million dollars in donations over the past decade to the political campaigns of President Obama and other prominent Democrats. He has recently come under scrutiny related to cardiovascular treatment centers he operates in Central Florida.
Data indicate that Qamar was paid in excess of $18 million in 2010, making him and Melgen, by far, the largest Medicare-payment recipients nationwide. A New Jersey pathologist received the third-largest Medicare reimbursement valued at $12.6 million.
In an interview with the Times, Qamar said questions regarding his reimbursement were not justified.
"Just looking at the sheer volume of work and billings from a single physician is not a sign of wrongdoing," Qamar said, adding that his practice takes care of cardiac procedures in its outpatient clinics that would normally be done in hospitals in many other states and that accounts for the large billable amounts.
The Times reported that Florida was home to many of the physicians who received the largest Medicare reimbursement amounts -- 28 out of 100. California, which has a much larger population, was second, with 10 in the top 100.
Billing three to four times what it costs
More from the Times:
Doctors in Florida have been frequent targets of Medicare fraud investigations, based on irregular patterns of bills or extremely high bills.
Just last month, two Florida medical clinic owners were sentenced on charges of Medicare fraud, both in cases involving more than $20 million in fraudulent payments. In addition, the Halifax Hospital Medical Center in Daytona Beach, Fla., agreed to pay the government $85 million to resolve allegations that it had billed Medicare for care based on referrals from doctors who had a financial relationship with the institution, a forbidden practice.
Melgen came to the attention of investigators when a Medicare contractor noticed that he, as a single practitioner, was billing for Lucentis at a much higher rate than his peers, said Justice Department lawyers in a written response to a suit the physician filed against HHS.
Each vial of the medication comes with up to four times the amount that a patient needs, the Times said. Investigators found that the doctor was using one vial to treat three or four patients, and then billing as though he had purchased a new vial for each one. As such, Melgen would be reimbursed $6,000 to $8,000 for a vial of medication that only cost him $2,000.
"The investigation concluded that in 2007 and 2008 alone, he overbilled by $9 million, which he was forced to pay back," the Times reported. Sources: