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  1. #1
    Super Moderator Newmexican's Avatar
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    Sen. Menendez contacted top officials in friend’s Medicare dispute

    Sen. Menendez contacted top officials in friend’s Medicare dispute

    By Carol D. Leonnig and Jerry Markon, Wednesday, February 6, 8:28 PM

    Sen. Robert Menendez raised concerns with top federal health-care officials twice in recent years about their finding that a Florida eye doctor — a close friend and major campaign donor — had overbilled the government by $8.9 million for care at his clinic, Menendez aides said Wednesday.

    Menendez (D-N.J.) initially contacted federal officials in 2009 about the government’s audit of Salomon Melgen, complaining to the director overseeing Medicare payments that it was unfair to penalize the doctor because the billing rules were ambiguous, the aides said.

    Last year, in a meeting with the acting administrator of the agency in charge of Medicare and Medicaid, Menendez again questioned whether federal auditors had been fair in their assessment of Melgen’s billing for eye injections to treat macular degeneration, the senator’s aides said.

    The agency had ordered Melgen to repay the $8.9 million, and at the time of both conversations, Melgen’s appeal was pending. That appeal is unresolved.

    Menendez’s office provided this account of his contacts with the Center for Medicare and Medicaid Services after The Washington Post asked about the role he had played in the long-standing dispute between Melgen and the agency over his billing practices.

    Menendez, who became chairman of the Senate Foreign Relations Committee this month, is under scrutiny because of his close relationship with Melgen. The doctor donated more than $700,000 last year to Menendez’s reelection campaign and other Senate Democrats. And when Melgen needed help with a port security contract in the Dominican Republic last year, Menendez urged U.S. officials to press the country to carry out the multimillion-dollar agreement.

    Menendez is facing a Senate ethics inquiry about two free trips he took in 2010 on Melgen’s private plane to the doctor’s seaside mansion in the Dominican Republic. Menendez acknowledged this month that he had not properly disclosed the trips. He wrote a personal check for $58,500 to reimburse Melgen.

    Meanwhile, a federal investigation of what law enforcement officials say are allegations of health-care fraud by Melgen escalated last week when FBI agents and health-care investigators raided medical offices in West Palm Beach where he runs Vitreo-Retinal Consultants. The teams spent nearly 24 hours searching the premises and removing dozens of boxes containing billing and medical records and computer files.

    Federal investigators and health-care auditors have had concerns about Melgen’s billing practices at various times over the past decade, two former federal officials said.

    In part, they have examined the volume of eye injections, surgeries and laser treatments performed at his West Palm Beach clinic.

    But a Menendez aide said Wednesday that the senator did not know Melgen was under formal investigation for possible fraud until the well-publicized raid last week.

    “Senator Menendez was never aware of and has not intervened in any Medicare fraud investigation on behalf of Vitreo Retinal Consultants,” his office said in a statement.

    The senator’s conversation with federal officials about Melgen’s case was unrelated to the current investigation, Menendez aides said.

    “On a separate issue regarding Medicare reimbursement, he has in the past raised concerns with CMS about conflicting guidelines and ambiguity in CMS rules that are difficult for providers to understand and can lead to judgments after the fact,” the statement said. “His interest was in making sure providers were not penalized if CMS clarified or changed the rules of the game retroactively.”

    Alan Reider, Melgen’s attorney, said Wednesday that his client has returned the government money in dispute but is contesting the CMS audit finding so he can reclaim the money. Reider said Melgen believes he was following Medicare guidelines. Reider added that Melgen was not aware that his practice was under investigation until federal agents arrived at his clinic last week.

    At issue in the reimbursement dispute is Melgen’s multiple use of individual vials for eye injections to treat macular degeneration. Federal auditors have said Melgen often billed the government three to four times for injections from a single vial, according to two federal officials and lawyers familiar with the case.

    The government’s Medicare program reimburses providers $2,000 for each vial, so Melgen was billing $6,000 to $8,000 for each vial.

    Melgen’s attorneys said the doctor was properly billing for treating four patients with medical injections, albeit from one vial.

    After CMS ruled in 2008 that Melgen would have to repay the government, he and his legal representatives contacted Menendez’s office, arguing that the finding was unfair, the senator’s aides said. Menendez’s staff members had several conversations with agency officials to learn more about the billing rules and the details of Melgen’s case in particular, the aides said.

    In July 2009, Menendez called Jonathan Blum, the Medicare director at CMS, to express concern, the aides said. Menendez brought up Melgen’s case, they said, in the context of broader concerns about the guidelines.

    Then, in June 2012, Menendez raised Melgen’s case again at meeting with CMS Acting Administrator Marilyn Tavenner, aides recounted. They said the primary subject of the meeting was the implementation of President Obama’s health-care overhaul.

    The aides said Menendez never urged the CMS to take specific action on Melgen’s case.

    Blum and Tavenner declined to comment through a spokeswoman for the Department of Health and Human Services.

    Melgen frequently cited his connection to Menendez, according to two former federal officials and doctors in southern Florida.

    When federal health-care fraud investigators were questioning Melgen several years ago about his billing practices, he repeatedly invoked Menendez, according to two former senior federal officials.

    “He used Menendez’s name all the time. He would say, “Menendez is a good friend of mine, and he knows I never did anything wrong,’ ” said a former senior federal official familiar with the investigation.

    In Florida, it was more threatening, several doctors in the South Florida region recounted. After one local eye surgeon criticized Melgen’s treatment methods in discussions with other Florida doctors, Melgen warned that he had important friends in the Senate, including Menendez, said two doctors familiar with the exchange. They said Melgen cautioned that his Washington friends could arrange an intensive federal audit of the surgeon’s practice.

    Reider, the attorney, said he had no knowledge of any comments Melgen may have made mentioning his friendship to Menendez.

    Melgen came to the attention of fraud investigators amid complaints from other local eye doctors alleging that his treatments were often unnecessary, a waste of money and sometimes harmful to patients’ eyesight, the two former federal officials and several doctors said.

    At the same time, investigators considered him an “outlier” compared with his peers because of the volume of his billing and the rate at which he administered eye injections and performed procedures on government-insured patients, the former officials said.

    They spoke on the condition of anonymity because the investigation is still ongoing.

    Melgen “was somebody who consistently showed up on the radar and was being looked at quite a bit,” said a former senior health-care fraud investigator. “The sheer volume itself is going to keep him on the radar.’’

    When federal investigators interviewed Melgen, he tried to exert pressure on them by mentioning the names of Menendez and other influential politicians, the former fraud investigator said. “We thought it was odd because Menendez was in New Jersey and this guy was in Florida,’’ the official said.

    A second former federal official recounted that Menendez’s name came up repeatedly when Melgen was interviewed by investigators from the Justice Department and the inspector general’s office at the Department of Health and Human Services.

    “He was using Menendez more as a character reference,” the official said. “He thought he was untouchable.”

    The federal interest in Melgen stretches back 10 years, when investigators interviewed Philip Rosenfeld, a nationally known retina specialist, about the volume of treatments Melgen was performing, said several eye doctors in south Florida.

    These doctors said Rosenfeld, who pioneered the use of Avastin injections for macular degeneration to stem eyesight loss, had long been troubled by Melgen’s methods.

    FBI agents recently interviewed Rosenfeld again, this time two days before they raided Melgen’s clinic, the doctors said.

    Reached at his home in Key Biscayne, Rosenfeld declined to comment.

    Doctors in south Florida said that they have been fearful of criticizing Melgen publicly, and that his Washington connections may be protecting him.

    In 2010, Melgen scolded eye surgeon Randy Katz for publicly criticizing the quality of his care. According to two fellow doctors, Melgen cited his Senate connections and told Katz that he could face a Medicare investigation.

    Katz did not respond to requests for comment. Melgen’s attorney declined to discuss his client’s conversations with Katz or allegations that his client had threatened other doctors.

    Soon after the encounter, according to a copy of a letter obtained by The Post, Katz wrote an open letter to Palm Beach doctors in praise of Melgen.

    “It has come to my attention that certain statements I made have been misunderstood as criticisms of Dr. Melgen,” Katz wrote. “To be clear, I know Dr. Salomon Melgen to be a capable and highly-skilled vitreo-retinal surgeon. . . . If you hear any suggestion that I have said otherwise, you should disregard that suggestion as being false.”

    Alice Crites contributed to this report.

    Sen. Menendez contacted top officials in friend’s Medicare dispute - The Washington Post

  2. #2
    Super Moderator Newmexican's Avatar
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    HHS OFFICIAL: MELGEN THOUGHT HE 'WAS UNTOUCHABLE' BECAUSE OF MENENDEZ

    HHS OFFICIAL: MELGEN THOUGHT HE 'WAS UNTOUCHABLE' BECAUSE OF MENENDEZ



    by MIKE FLYNN 7 Feb 2013

    According the developing accounts, NJ Sen. Bob Menendez has a special relationship with mega-donor Dr. Salomon Melgen. In addition to campaign contributions, Dr. Melgen allegedly flew Sen. Menendez to the Dominican Republic on his private plane and may have provided the Senator with prostitutes. That soap opera, though, obscures a more troubling connection. According to areport in the Washington Post, Sen. Menendez intervened at least twice on behalf of Melgen in a billing dispute he had with Medicare.

    Since at least 2009, Dr. Melgen, a Florida eye surgeon has been in a billing dispute with Medicare. At issue is billing over a vial of medicine used in surgery to treat macular degeneration. Under Medicare billing practices, the system reimburses medical offices $2,000 for each vial. Dr. Melgen broke the vial into 3-4 individual doses, billing Medicare $6-8,000 for each vial. Medicare's original complaint alleged that Dr. Melgen had improperly billed Medicare $8.9 million.

    Medicare billing is notoriously complicated. It is also entirely possible that Melgen's dilution of the medicinal vial was medically appropriate. At any given moment, there are likely dozens of billing disputes being debated between Medicare and doctors' offices. It is unusual, however, that a US Senator weighs in.

    According to the Post, Sen. Menendez pressed HHS officials on the matter on at least two occasions. The first was a phone call in 2009 to Jonathan Blum, the Medicare director for HHS. The second was in 2012, in a meeting ostensibly to discuss implementation of ObamaCare.

    It is important to note that Dr. Melgen is not a constituent of Sen. Menendez. He does not practice medicine in New Jersey. Outside of campaign contributions, he has no ties to the Senator that might in other cases trigger a Senator's intervention on behalf of a constituent. Yet, according to officials, Dr. Melgen frequently cited his ties to Menendez.

    A second former federal official recounted that Menendez’s name came up repeatedly when Melgen was interviewed by investigators from the Justice Department and the inspector general’s office at the Department of Health and Human Services.

    He was using Menendez more as a character reference,” the official said. “He thought he was untouchable.
    The current Menendez saga began with a sex scandal. The full truth of his relationship with Dr. Melgen is more troubling. Just one month after his last reported intervention with Medicare officials on Melgen's behalf, Sen.

    Menendez used his perch on a Foreign Affairs Subcommittee to press State Department officials to take action with the Dominican Republic that would financially reward Melgen.

    That is a lot of quid to whatever quo Melgen might have been providing.

    HHS Official: Melgen Thought He 'Was Untouchable' Because of Menendez


  3. #3
    Super Moderator Newmexican's Avatar
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    Web of Influence

    Ties between Menendez and controversial donor more extensive than previously thought

    b Menendez, Salomon Melgen / VOXXI

    BY: Mary Lou Byrd

    February 11, 2013 9:00 am

    A controversial Democratic donor now under federal investigation has affiliations with numerous Latino groups that have allowed him access to high-level Obama Administration officials.

    United States Spain Council (USCC), a 501(c)(3) nonprofit organization, lists SFM Holdings, of which Melgen is the president and general partner, as an organizational member of the council.

    Melgen’s connection to USSC links him to his long-time friend Sen. Bob Menendez (D., N.J.). Menendez is the honorary chairman of the council.
    Both Menendez and Melgen are under investigation. Menendez is facing a Senate ethics probe for his relationship with Melgen while the FBI and Department of Health and Human Services is investigating Melgen for possible Medicare fraud.

    Menendez and Melgen are also under suspicion for Menendez’s intervention on Melgen’s behalf regarding a port security contract.

    Melgen, Menendez’s top contributor and a heavy contributor to the Majority PAC run by former lieutenants of Senate Majority Leader Harry Reid (D. Nev.), stood to make between $500 million and $1 billion over 20 years if that contract was enforced.

    Menendez’s former aide, Pedro Pablo Permuy, is the president of USCC. Permuy could also have benefitted from the Dominican Republican port security contract, which Menendez advocated in talks with State Department officials and at a hearing over which he presided last July, according to aNew York Times report.

    Menendez claimed he did not know Permuy was involved in the port contract. Permuy denied being either a board member or an employee of the port security company.

    “His answer was coy,” said Ken Boehm, chairman and co-founder of the National Legal and Policy Center. Boehm noted that Permuy did not answer the question, but rather stated he was not currently affiliated with the company.

    Boehm pointed out that Permuy has worked for Menendez for years during his tenure as a congressman and said the senator was being “more than disingenuous” to indicate he was shocked his former aide would be involved in the port security deal.

    The USSC’s mission is bringing “U.S. and Spanish corporate leaders, top government officials, and leaders in education and culture promote stronger ties between the two countries,” according to its website.

    The U.S. Spain Council did not respond to requests for comment.

    Another key member of the council is Univision, which has largely avoided stories on the Menendez scandal. Univision did not respond to request for comment.

    Former Secretary of State Hillary Clinton, transportation secretary Ray LaHood, and other top officials from the Obama administration attended the council’s 2012 forum in New Jersey. Clinton thanked Menendez and Permuy in her opening remarks:

    I also want to thank my long-time friend and former colleague – I think it’s fair to say that Senator Bob Menendez is truly one of the most effective, determined, dedicated public servants in our country. … Thanks also to Juan and Pedro [Permuy] for their co-chairing and presidency of the U.S.-Spain Council.
    Melgen is also a member of the New America Alliance (NAA), a group co-founded by Henry Cisneros. VOXXI, the media company of which Melgen is the chairman of the board, is a media partner of the NAA, and Univision is also a sponsoring organization of the NAA.

    Menendez’s affiliation with the NAA includes his attendance at many of its summits. He also initiated one of the NAA’s goals, issuing a press release asking Fortune 500 companies to identify the number of Hispanics on its corporate boards and serving in senior level positions. The NAA’s goal was to increase Hispanics serving in high-level jobs in major corporations and at financial institutions.

    The NAA asked “what the story is regarding and what about NAA will be mentioned” before agreeing to comment on the connection. Questions sent by email to NAA’s Lisa Rodriguez regarding Melgen’s membership and its partnership with VOXXI went unanswered. Additionally, a question about whether the NAA does vetting of its members was not answered.

    Univision president Cesar Conde gave the opening remarks at the NAA’s First American Latino National Summit held in Florida last September. The moderator at the summit was Maria Eleana Salinas, who is the co-host “Noticiero Univision” and “Aqui y Ahora.” The summit’s sponsors included Univision and VOXXI.

    Other high-level Democrats have also attended other NAA events. The NAA’s 10th anniversary gala was attended by many in the Obama administration, including President Obama’s senior adviser Valerie Jarrett; outgoing secretary of the interior Ken Salazar; White House director of urban affairs policy Adolfo Carrion; deputy director of the National Economic Council Diana Farrell; White House director of intergovernmental affairs Cecilia Munoz; and director of administration Moises “Moe” Vela.

    Sens. Menendez and Mark Warner (D., Va.) and Reps. Charles Gonzales (D., Texas), Jim Himes (D., Conn.), and Nydia Velazquez (D., N.Y.) also attended the gala.

    Another Latino group, the nonprofit National Hispanic Media Council (NHMC), issued a statement last week defending Menendez, saying it stood with the New Jersey senator “as some in the ‘news’ media use unsubstantiated allegations to smear him. The senator has devoted his life to serving the public and deserves to be judged based on facts, not hearsay.”

    The Free Beacon asked for clarification of the statement in an email exchange with Inez Gonzalez, the executive vice president of the NHMC.

    “We don’t think that all the stories referring to the senator are an attack on his character,” Gonzalez said. “Late yesterday, after our statement went out, the Washington Post released an investigative piece on the senator. Our statement referred to conservative websites such as the Daily Caller and also Bill O’Reilly who rely on anonymous sources to spread allegations linking the senator with underage prostitution.”

    Daily Caller Spokeswoman Nicole Roeberg disputed the NHMC’s comments.

    “Our sources were not anonymous. We didn’t release their names, but we posted their videos on our website, with their faces blocked out, to respect their privacy,” she said. The women interviewed from the Dominican Republic told the Daily Caller they were “paid to have sex with the senator, and they do have names and faces,” said Roeberg.

    Fox News did not respond to requests for comment.

    The NHMC did not have comment on the other “unrelated allegations,” said Gonzalez.

    “NHMC wasn’t aware that Dr. Melgen had a media company, we don’t know Dr. Melgen,” Gonzalez said when asked about Melgen’s possible ties to the NHMC. “As far as I know, we have had no dealings with him or his company.”

    However, the NHMC’s claim that it had no dealings with Melgen’s company, VOXXI, is not the case. The Free Beacon found numerous stories in which VOXXI interviewed and quoted the NHMC president in articles and the NHMC president was a panelist alongside VOXXI’s president at an NAA summit.

    Controversial Dem donor and Dem senator share many connections | Washington Free Beacon

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