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Stakes couldn’t be higher in health care fraud sentencing

On Behalf of | Dec 10, 2017 | Health Care Investigations |

Last month, New York City media outlets reported that the months-long bribery trial of Sen. Robert Menendez and co-defendant Dr. Salomon Melgen had ended in mistrial. Earlier this year, Melgen had been convicted of Medicare fraud, but sentencing in that case was postponed until the bribery trial was concluded.

Defense attorneys and prosecutors recently presented starkly different accounts of the eye doctor’s crimes as sentencing proceedings resumed. Prosecutors are arguing for a decades-long sentence for the 63-year-old Harvard-trained ophthalmologist while defense lawyers counter that his fraud was relatively minor and does not deserve harsh punishment.

Melgen’s attorneys are arguing that prosecutors have only demonstrated that Melgen pilfered about $64,000. They concede that he submitted false billing for the 30 patients selected as a representative sample of the more than 2,000 that the doctor treated between 2008 and 2013.

The attorneys are asking for a short sentence — perhaps as short as time already served.

Prosecutors are telling a story from the opposite end of the spectrum, asking that Melgen be sentenced to 30 years for subjecting elderly patients to tests and treatments for diseases they did not have so that he could bill Medicare and support a lavish lifestyle.

They say Melgen often saw more than 100 Medicare patients a day in order to pay for a vacation home, trips to Europe and business investments.

In April, a jury found Melgen guilty of health care fraud, falsifying patient records and submitting false claims to Medicare.

We do not know how severe Melgen’s punishment will be, but we do know that if the prosecution’s argument carries the day, the doctor is looking at the possibility of spending the rest of his days in a federal prison. Stakes could hardly be higher.

If you are being investigated for matters that could involve health care fraud, you should have legal representation to protect your rights and interests at every step of the process.

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