State knew of abuses, did almost nothing

By Marshall Allen

Monday, Aug. 4, 2008 | 2 a.m.

State officials have said for more than a year that they were unaware of complaints from foreign physicians that their bosses — most of them prominent immigrant doctors in Las Vegas — were getting rich by exploiting a program designed to help communities lacking medical providers.

Now the state is acknowledging that it received at least six letters from foreign physicians complaining about their employers.

The employers were hiring the foreign doctors under a federal mandate that they work full time in medically underserved communities. But the Sun found in its 2007 “Indentured Doctors” investigation that the bosses enriched themselves by diverting their physician-employees to more affluent areas where they could make more money. In some cases they also exploited doctors by working them to exhaustion and not paying their contracted salaries.

During the Sun’s investigation, state health officials in charge of the “J-1” program adamantly denied any knowledge of abuses. When the Sun published its findings, state officials claimed the abuses were news to them. They then set out to reform the program.

But a state report released Thursday that reviews the J-1 program from 2001 to 2008 reveals the state’s knowledge of the foreign doctors’ complaints.

And little was done about them, the report said.

Employers can get away with taking advantage of their foreign employees because in addition to paying the foreign doctors’ salaries, they sponsor their visas. Thus, standing up to an abusive boss could result in losing a visa and getting deported.

The complaints listed in the state report are similar to those detailed in the Sun’s investigation:

• One physician said there was no functioning clinic in the underserved area where he was supposed to see patients.

• Two doctors who worked for the same employer alleged they had been ordered to work in areas that were not considered underserved by the federal government, a violation of the law. They also claimed their employer did not have enough money to pay them, and that the boss falsified documents to the state. The state helped the doctors find other jobs, and the original employer is no longer in business, the report said.

• A physician claimed she was assigned to areas where there was no shortage of medical providers, was not paid and did not receive promised health benefits. She also said her boss tried to make her take out a $100,000 loan to fund the clinic where she was employed, a violation of federal law. The Nevada attorney general’s office was notified by the state Health Division, the report said. The sponsor is no longer in business.

• A fifth doctor said he was forced to work at sites that were not part of his contract and was not paid the agreed upon salary. He was required to take out a $150,000 loan for the employer, his complaint said.

• A sixth doctor claimed his sponsor tried to make him work in San Bernardino County, Calif., and that other Nevada J-1 doctors who worked for the same employer were assigned to the same clinic. The physician left the state. There is no evidence the state intervened, the report said.

• A seventh complaint was filed by a person who worked with one of the J-1 doctors forced to work in San Bernardino. The employee complained of the doctor’s being sent to California, instead of the underserved area in Nevada, and falsifying documents to the state. The state never took any action on the complaint, the report said.

A former J-1 doctor told the Sun the revelations that past complaints were ignored show that “corruption is everywhere.”

“In the Third World, where I come from, you see it,” the foreign doctor said. “But it is everywhere. It’s just done in different ways.”

The complaints reveal what he and others have said was common knowledge: that the abuses of the J-1 program were blatant, systematic and widespread.

The former J-1 doctor said he’d complained to the state by phone about his employer, and knows of other complaints to the state not noted in last week’s report.

“You don’t know who to trust,” one foreign doctor said. “If the health department did know about (the abuses), then where would you go? You just have to suffer.”

Some of the employers named in the Sun’s investigation are influential members of the medical community. Dr. Rachakonda D. Prabhu, who has hired more J-1 doctors than anyone in the state, has been appointed by governors to advisory committees and was invited to the White House during a state visit by the Indian prime minister. His entire business model was built on J-1 doctors hired at his North Las Vegas and Pahrump clinics. Several doctors who worked for Prabhu said he did not allow them to work the required time in the underserved areas.

The Sun investigation has prompted the state to overhaul its oversight of the J-1 program, including holding public meetings with an advisory council to consider applications and policy related to the program.

Lynn O’Mara, the state official now in charge of J-1 oversight, said she couldn’t comment for this story because the report will be presented at the advisory council’s meeting Thursday. But she has said that she is determined to stop the abuses.

Assemblywoman Sheila Leslie, D-Reno, who brought the issue to the Legislative Health Care Committee, which she leads, said there is no evidence of corruption, but she would like to know why more action was not taken on the complaints.

It’s possible that O’Mara just found the complaints in a file and made them public, Leslie said, which would bode well for the future of the program.

“If indeed they found these complaints and they’re being honest and transparent about it, that would be a tremendous amount of progress,” Leslie said.