U.S. attorney accuses LV medical practice of fraud

By Steve Green (contact)

Published Wednesday, March 18, 2009 | 2:10 p.m.

Updated Wednesday, March 18, 2009 | 7:16 p.m.

The U.S. attorney's office is suing a Las Vegas medical practice, accusing it of defrauding two federal agencies by performing thousands of unnecessary cholesterol tests on patients.

In a lawsuit filed this week in U.S. District Court, the United States claims Miller Medical Group Chtd., which does business as Internal Medicine Associates, violated the federal False Claims Act by submitting fraudulent invoices to Medicare and the Federal Employee Health Benefit program, which provides health insurance to federal workers.

Miller Medical Group has not yet responded to the allegations and officials there could not be reached for comment Wednesday.

The lawsuit is part of a wider review of billing practices involving Internal Medicine Associates, where three doctors associated with the business have agreed to pay tens of thousands of dollars to settle federal claims against them.

The government claims that from 2003 to 2006, Internal Medicine Associates billed Medicare and the federal employees' health program, as well as other insurers, for two types of blood tests measuring cholesterol: One measuring HDL (high-density, or good) cholesterol and another measuring LDL (low-density, or bad) cholesterol.

The government alleges many of the LDL tests were not medically appropriate because, except in cases of very high HDL, the level of LDL could be determined by applying a mathematical formula to the HDL results.

The suit says during the three-year period, the "defendant performed services for federal health care beneficiaries but prepared or caused to be prepared materially false or fraudulent records or statements, and presented or caused to be presented to the United States materially false or fraudulent claims for reimbursement.''

"Medicare and (the federal employee insurance) policy provided that a directly-measured LDL would not be appropriate, and therefore payment would be denied, if the direct LDL analysis was performed on the same day for a patient who had received a lipid panel test, unless the patient’s triglyceride (cholesterol) level was too high to permit reasonably accurate calculation of the LDL level,'' the government alleges.

The suit, which alleges more than 15,000 violations of the False Claims Act, seeks restitution for the government as well as triple the government's proven damages as allowed by the act.

Natalie Collins, spokeswoman for the U.S. Attorney's Office, said the loss to the government because of the alleged improper billing was about $130,000.

The suit follows recent settlements involving three doctors or former doctors at Internal Medicine Associates. The government said all three doctors had submitted claims for unnecessary LDL tests. The doctors, who did not admit liability, and their settlements were Dr. James Eels for $10,854; Dr. Mark Handelman for $39,070 and Dr. Glen Meyers for $13,341.

Steve Green can be reached at 990-7714 or steve.green@hbcpub.com.