Doctor vs. doctor in Medicare fraud conviction

Gavel and flag in courtroom
A Florida eye doctor tells why he testified in a fraud case against another doctor. (Getty/AlexStar)

When a jury convicted a Florida retina surgeon on 67 counts of Medicare fraud in April, the prosecution depended on the testimony of another eye doctor to help present its case.

Adam Berger, M.D., was asked to testify as an expert witness in the trial of Salomon Melgen, M.D., a West Palm Beach doctor. Berger, a doctor at The Center for Retina & Macular Disease in Winter Haven, Florida, described his role in the court case in an article on MedPage Today.

“When I was asked under oath why I had agreed to testify in the case, I responded this way: I have been given a gift, and it is a great privilege to use that gift every day in the service of my community and the patients entrusted to my care. But with that privilege comes responsibility, and one of those responsibilities is to defend the integrity of my profession and speak out when I see patients being defrauded and the standard of care being violated,” wrote Berger about his decision to testify in the case. Berger did not receive any payment for his testimony.

Melgen, who collected more money from Medicare than any other physician in the country in 2012, was found guilty of up to $105 million in Medicare fraud and faces 15 to 20 years in prison.

Prosecutors said Melgen stole up to $105 million by performing unnecessary tests and treatments on mostly elderly and disabled patients, prosecutors said. Melgen diagnosed almost every patient he saw with wet age-related macular degeneration and relied on antiquated technology to make that diagnosis rather than the test retina specialists across the country use. Melgen treated patients with unproven procedures without their knowledge or consent and then tried to trick Medicare into paying by billing under a different code, Berger said.

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The high-profile case hit close to home for Berger. Another retina specialist, who until recently was in practice with him, Michael J. Tolentino, M.D., testified for the defense.

Melgen isn’t alone in his scam of the Medicare system. Last year, Berger also testified in the trial of David Ming Pon, M.D., who in March was sentenced to 10 years in federal prison in a similar fraud case. Pon, a Florida ophthalmologist, was sentenced for cheating Medicare out of nearly $10 million by intentionally misdiagnosing patients and then giving them phony laser treatments.