For all the health concerns triggered by the hepatitis C outbreaknearly two years ago, another matter related to the medical scandal has yet to be resolved: an investigation into possible insurance fraud.

The ongoing investigation is the largest of its kind undertaken by the Nevada attorney general’s office.

Several sources have said the clinic that caused the outbreak, Endoscopy Center of Southern Nevada, made a habit of overbilling insurance companies.

The Southern Nevada Health District said as much in its recent final report: “Staff members reported that anesthesia times were intentionally recorded incorrectly for the purposes of obtaining additional reimbursement ... Times for procedures shorter than 30 minutes in length were typically reported as 31 or more minutes,” which triggered larger payments to the clinic.

Sources at the clinic, which was majority-owned and run by Dr. Dipak Desai, a former president of the Nevada State Board of Medical Examiners, have told the Sun the same thing. One nurse said every procedure was billed for at least 30 minutes of anesthetic.

In a malpractice lawsuit against Dr. Clifford Carrol, one of the clinic’s owners, court documents showed certified nurse anesthetist Ronald Lakeman documented 31 minutes of anesthesia time — even though the patient’s procedure lasted just eight minutes.

Las Vegas anesthesiologist Dr. Joseph Schifini, who reviewed the Endoscopy Center’s anesthesia records, said 31 minutes of anesthesia time was highly unlikely for an eight-minute exam. Lakeman had noted in a medical record that he monitored the use of anesthesia 25 minutes after the intravenous catheter was removed by a recovery nurse, Schifini said.

The 31 minutes is significant because anesthesia is billed to insurance companies in 15-minute increments, Schifini said, allowing the Endoscopy Center to bill for three 15-minute time frames because of the extra minute.

Full story