The pattern of large Medicare payments and six-figure political donations shows up among several of the doctors whose payment records were released for the first time this week by the Department of Health and Human Services. For years, the department refused to make the data public, and finally did so only after being sued by The Wall Street Journal.
Dr. Melgen’s firm donated more than $700,000 to Majority PAC, a super PAC run by former aides to the Senate majority leader, Harry Reid, Democrat of Nevada. The super PAC then spent $600,000 to help re-elect Senator Robert Menendez, Democrat of New Jersey, who is a close friend of Dr. Melgen’s. Last year, Mr. Menendez himself became a target of investigation after the senator intervened on behalf of Dr. Melgen with federal officials and took flights on his private jet.
Another physician, Dr. Asad Qamar, an interventional cardiologist in Ocala, Fla., has sent at least $250,000 in donations over the last decade to the political campaigns of President Obama and other prominent Democrats; he has become the target of scrutiny related to cardiovascular treatment centers he runs in Central Florida.
Dr. Qamar was paid more than $18 million in 2012, making him and Dr. Melgen by far the largest payment recipients nationwide, according to the data. A pathologist from New Jersey received the third largest Medicare reimbursement, $12.6 million.
In an interview on Wednesday, Dr. Qamar said any questions about his Medicare bills were unjustified.
“Just looking at the sheer volume of work and billings from a single physician is not a sign of wrongdoing,” Dr. Qamar said, noting that his practice handles cardiac procedures in its outpatient clinics that would be done inside a hospital in many other states, which he said explained the large billable amounts.
The state of Florida was home to many of the physicians who received the largest payments, 28 out of the top 100. California, with a much larger population, was second, with 10 of the top 100.
Doctors in Florida have been frequent targets of Medicare fraud investigations, based on irregular patterns of bills or extremely high bills.
Just last month, two Florida medical clinic owners were sentenced on charges of Medicare fraud, both in cases involving more than $20 million in fraudulent payments. In addition, the Halifax Hospital Medical Center in Daytona Beach, Fla., agreed to pay the government $85 million to resolve allegations that it had billed Medicare for care based on referrals from doctors who had a financial relationship with the institution, a forbidden practice.
Dr. Melgen appeared on investigators’ radar when a Medicare contractor noticed that he, a single practitioner, was billing for Lucentis at a significantly higher rate than his peers, Justice Department lawyers wrote in response to a suit the doctor filed against the Health and Human Services Department.
The investigation concluded that in 2007 and 2008 alone, he overbilled by $9 million, which he was forced to pay back.
The doctor, federal lawyers said, “seeks to game the system by seeking reimbursement of three to four times its actual costs.”