Yesterday the Washington Post posted an article about Senator Robert Menendez and his relationship with Florida eye surgeon Salomon Melgen. The headline of the article reads, “Sen. Menendez contacted top officials in friend’s Medicare dispute.”

At the center of this controversy is a federal investigation into the billing practices of Dr. Melgen. The article details a history of federal inquiries into the billing records of Dr. Melgen culminating with an FBI raid on the doctor’s office at the end of January this year.

The article reports:

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.

There is also an incident in the article where another doctor criticized Dr. Melgen, and Dr. Melgen threatened the other doctor with a Medicare investigation.

There are a few aspects of this story. There is the salacious part about the underage girls and the private jet trips, but there is also the implication that Medicare fraud is a significant problem. I understand that a Medicare investigation is probably a major pain in the neck for a doctor, but it disturbs me that it could be used as a threat by a doctor who was seen as being able to carry out the threat. That really does not say a lot about the integrity of either our government or of Medicare.