Here’s yet another case where patients’ records were allegedly purposefully corrupted to support a fraud scheme – resulting in patients allegedly getting serious surgeries and injections they didn’t need, and putting them at risk for future improper treatment should those records be used by others.
Salomon E. Melgen, 60, is an ophthalmologist and retina specialist licensed to practice medicine in the state of Florida. Melgen owned and operated Vitreo-Retinal Consultants of the Palm Beaches and conducted business as Vitreo Retinal Consultants Eye Center and The Melgen Retina Eye Center with four offices located in Palm Beach and St. Lucie Counties. A large percentage of Melgen’s patients were Medicare beneficiaries.
Melgen was charged in a seventy-six count indictment with 46 counts of health care fraud, 19 counts of making, presenting and filing false, fictitious and fraudulent claims and 11 counts of making false statements relating to health care.
According to allegations in the indictment, from as early as 2004 and continuing through at least Dec. 31, 2013, Melgen submitted false claims and created fraudulent entries on patients’ medical charts to support those claims. Melgen is alleged to have falsely diagnosed patients with serious eye conditions, notably age-related macular degeneration (ARMD or AMD) and retinal disorders. Based upon the false diagnoses, he would allegedly perform and bill for medically unreasonable and unnecessary tests and procedures, which included unnecessary laser surgeries and eye injections.
The defendant is also alleged to have caused patient files to contain false information, including the false diagnoses as well as fictitious drawings and diagrams that misrepresented the condition of the patients’ eyes. The indictment also alleges that the defendant prepared false and fictitious reports regarding his abnormal billing practices, in response to audit inquiries from Medicare.
Additionally, the defendant allegedly submitted claims for incomplete and non-performed diagnostic tests, such as angiographic studies on blind eyes and prosthetic eyes.
There’s more to the allegations that you can find on the U.S. Attorney for the Southern District of Florida’s web site.
And now for the mandatory disclaimer:
An indictment is only an accusation and the defendant is presumed innocent unless and until proven guilty.