Mistakes or Fraud?

The issue has been framed as "mistakes vs. fraud" in the Melgen trial, which is now with the jury.  From the PBP:

Acknowledging Dr. Salomon Melgen made some mistakes as he struggled to treat more than 100 patients a day at clinics from Delray Beach to Port St. Lucie, his attorney spent more than three hours Tuesday trying to overcome what federal prosecutors called “staggering” evidence that the ophthalmologist bilked Medicare out of as much as $105 million.

The 62-year-old Harvard-educated retinal specialist should not be found guilty of 76 charges of health care fraud for sloppy record-keeping, attorney Matthew Menchel told a federal jury in closing arguments. Further, he said, the doctor shouldn’t be sent to prison for trying innovative measures to help patients who were told their vision loss was hopeless.

While nationally renowned ophthalmologists testified during the nearly two-month trial that they were appalled by Melgen’s methods, Menchel insisted they had “agendas.” The people the jury should listen to are the patients, he said.

“It’s the patients who are experts in blindness,” Menchel said “It’s the patients, not the doctors, who are experts.”

Patients who testified — both for and against the wealthy physician who faces corruption charges in New Jersey with Democratic U.S. Sen. Robert Menendez — didn’t hold any animosity toward Melgen, he said. “Patients smiled warmly at him for a reason,” he said.

The reason, Assistant U.S. Attorney Roger Stefin countered, was that they that they had no idea he was using them as “props” to rake in millions from the federal insurer.

“He wasn’t just aggressive,” Stefin said, using Menchel’s word for Melgen’s tactics. “He was abusive. He took advantage of patients in many cases — people who were elderly, people who were sick, people who were trusting.”

Melgen subjected patients — some who had prosthetic, blind or shrunken eyes — to dozens of unnecessary and sometimes painful tests to “line his pockets with millions and millions of dollars,” agreed fellow Assistant U.S. Attorney Alexandra Chase.