Melgen, 63, is facing a possible life sentence after being found guilty of 67 counts, including health care fraud, submitting false claims and falsifying records in patients' files. Evidence presented during his trial earlier this year showed he subjected patients to unnecessary procedures, including sticking needles in their eyes and burning their retinas with lasers.
Melgen also stands accused in a separate federal case of bribing Democratic U.S. Sen. Bob Menendez of New Jersey in exchange for favors including visas for his foreign mistresses. As Melgen's three-day sentencing hearing began, some patients and former employees told U.S. District Judge Kenneth A. Marra that the Dominican-born, Harvard-trained doctor was an exceptional and giving doctor who often restored sight when the case seemed hopeless. Melgen listened quietly at the defense table, wearing a blue prison uniform, his legs shackled.
Bonnie Illsley, his former office manager, told the judge she never saw any evidence of fraud. Instead, she said she saw "a kind, generous man who would give you the shirt off his back." She said he would often meet emergency patients at his office at night or on weekends rather than send them to the emergency room, because he could provide better treatment.
Nestor Garcia said he suddenly lost his sight in 2009. Three doctors told him it was a lost cause, but Melgen restored some sight and treated him for free when his insurance company wouldn't pay. "He told me, 'Nestor, I have already started treating you. I don't care if your insurance pays me or not. I am with you to the end."
Dr. Adam Berger, a central Florida retinal specialist, testified for the prosecution that many of the tests and treatments Melgen performed on Medicare patients were "reckless," exposing the patients to potential infections and other risks. He called the 1-in-13 infection rate prosecutors found among a sample of Melgen's injected patients "astronomically high." He said the normal rate is 1-in-3,300 injected patients.
Anna Borgia told the judge that Melgen subjected her to painful injections and laser treatments for glaucoma and diabetes-related sight loss and then botched a surgery that left her nearly blind. She said she is now confined to her home listening to the television and depending on paid drivers to take her to the grocery store.
"I love dancing but what man wants to take a blind woman dancing?" she told the judge. "He ruined me. I hope the Dear Lord hears me when I pray at night that he gets life in jail and suffers the way I suffer."
Randy Frick had his attorney read a letter saying Melgen convinced his 90-year-old mother to undergo laser treatments and injections that he later learned were unnecessary because his mother has no eye disease. He said he feels complicit because he would drive his mother to her treatments.
"She underwent systemic torture at the hands of Melgen," Frick wrote. "I feel so guilty I have nightmares." Marra could give Melgen a life sentence, but he has wide discretion. Prosecutors are asking for 30 years. The defense argues he should spend no more than 10 years in a minimum-security prison camp.
Melgen's lawyers argued in court documents that prosecutors are exaggerating Medicare's loss. Attorneys Kirk Ogrosky and Matthew Menchel say a 30-year or life sentence, comparable to what terrorists get, is "irrational on its face." Because of Melgen's age and poor health, any lengthy sentence would be equivalent to a life term, they say.
They also say a sentence of 30 years or more would result in Melgen being housed in a maximum security prison, which they called "an unnecessary burden on the taxpayers," given his lack of criminal history. They want him sent to a minimum security camp, which they say would require a sentence of less than 10 years. Prosecutors dispute that, saying the federal Bureau of Prisons would decide his placement regardless.
Melgen has been in custody since his April 28 conviction. Separately, a federal jury in New Jersey hung last month after prosecutors there tried to prove Melgen's gifts to Menendez were actually bribes. In return, they say, Menendez obtained visas for Melgen's foreign mistresses, interceded with Medicare officials investigating his practice and pressured the State Department to intervene in a business dispute he had with the Dominican government.
Menendez and Melgen have denied wrongdoing in that case. Prosecutors have not said whether they will retry them.