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Date published: 2/8/2013
WASHINGTON--Sen. Robert Menendez acknowledged Wednesday that his office contacted U.S. health agencies in a way that would help the biggest political donor to his re-election, the same eye doctor whose private jet Menendez used for two personal trips to the Dominican Republic.
The senator denied to The Associated Press that he sought to intervene improperly in billing disputes between the doctor and the government.
Menendez, D-N.J., said he contacted the U.S. Centers for Medicare & Medicaid Services to ask about billing practices and policies. The contacts came during a dispute between CMS and Dr. Salomon Melgen, a longtime friend and campaign supporter of Menendez. The FBI searched Melgen's offices last week.
"The bottom line is, we raised concerns with CMS over policy and over ambiguities that are difficult for medical providers to understand and to seek a clarification," Menendez said.
The senator called federal health officials in 2009 and met with them again in 2012, each time urging them to change what he called an unfair payment policy that had cost his friend Melgen $8.9 million, according to an official close to the investigation who spoke on condition of anonymity because the person is not authorized to talk about ongoing investigations.
The official said Medicare held firm on the billing dispute and ordered the money repaid. It's unclear whether Melgen has repaid all or just some of the $8.9 million. He currently is appealing his case.
Medicare providers accused of fraudulent or improper billing are allowed to appeal their case, even after being fined or suspended from the program.
Melgen contends he didn't fraudulently bill the taxpayer-funded Medicare program but was confused about what was allowed, the official said.
Melgen treated patients suffering from macular degeneration with the costly drug Lucentis, which runs about $2,000 a vial. Melgen was only giving patients portions of the vial, which is allowed, but he was billing the government for the entire amount, the official said.
According to a 2012 report from the Health and Human Services inspector general, the agency recommended that Medicare officials stop using the drug because there was a cheaper alternative.