Board member in accused group

A member of the Nevada State Board of Medical Examiners practices medicine with the Las Vegas medical group accused by the U.S. attorney's office of defrauding two federal agencies by performing thousands of unnecessary cholesterol tests on patients.

Medical board member Dr. Javaid Anwar was not named in the lawsuit filed Monday against Miller Medical Group Chtd., but he is a longtime physician with the 20-year-old group, which does business as Internal Medicine Associates. No physicians were named in the complaint.

Anwar, past president of the medical board, which takes disciplinary actions against physicians, also served as president of the Miller Medical Group from 2000 to 2001, according to records filed with the Nevada secretary of state. Dr. Theresa Steckler is listed as the current president.

An assistant who answered the phone at Internal Medicine Associates offices said she would pass on messages seeking comment to Anwar, but he did not return calls.

Steckler also did not return repeated phone calls at the offices Thursday. The group has three offices in the Las Vegas Valley.

U.S. Attorney for Nevada Gregory Brower said Thursday that the fraud by the medical group "was carried out by its employees" from 2003 to 2006. He did not specify which employees were involved.

"I don't want to get into that detail right now," he said.

According to the lawsuit, Medicare and the federal employees' health program, and other insurers, were billed for two types of blood tests measuring cholesterol: One measures high-density lipoproteins, good cholesterol, known as HDL; the other measures low-density lipoproteins, bad cholesterol, known as LDL.

But many of the LDL tests were not appropriate, the government alleges, because except in cases when patients had very high triglycerides (fats in the bloodstream), the level of LDL could be determined by applying a mathematical formula to the total cholesterol, HDL and triglycerides.

The lawsuit said that each patient who was prescribed the HDL analysis "by his or her physician" automatically would receive that analysis and a "directly measured LDL analysis, regardless of the patient's level of triglycerides." But the LDL analysis would only be necessary if a patient's triglyceride level was dangerously high, the government said.

The medical group "presented or caused to be presented to the United States materially false or fraudulent claims for reimbursement," the lawsuit alleged.

The lawsuit alleges more than 15,000 violations of the False Claim Act.

"We're taking a hard look at health care fraud across the board," Brower said.

"The numbers are staggering when it comes to health care fraud being perpetrated against the federal government."

The lawsuit against the medical group seeks restitution for the government and triple the government's proven damages.

The government alleges the improper billing cost taxpayers about $130,000.

In an e-mail sent Thursday, Brian K. Berman, who is listed with the secretary state as an agent for the medical group, wrote: "We believe that we properly billed Medicare for laboratory tests we performed on nearly all our patients. ... Our group of Nevada physicians will continue to provide the same quality care for its patients as it has for over 20 years."

Berman wrote that Internal Medicine Associates "is a physician group of your neighbors" working with the elderly and ill who need "closer monitoring." He also said that the medical group "billed as directed by Medicare."

Brower said that was untrue.

Attempts to reach Berman by phone were unsuccessful. He did not reply to e-mail seeking follow-up information.

Brower said that the lawsuit against the medical group follows settlements involving three former group physicians.

Brower said that when they were notified they would be part of the lawsuit, they agreed to reimburse the government.

Those physicians are Dr. Mark Handelman, who settled for $39,070; Dr. Glen Meyers, who settled for $13,341; and Dr. James Eels, who settled for $10,854. In doing so, they did not admit liability.

Louis Ling, executive director of the Nevada Board of Medical Examiners, said Thursday that board officials will investigate.

"That's something we always do where alleged fraud is involved," he said.

He said that it is much too early to speculate on whether the allegations against the medical group would bear on Anwar's position on the medical board.

But Las Vegas physician Ivan Goldsmith, a longtime board critic who himself is under investigation by the board, said Thursday that Anwar "should immediately recuse himself from passing judgment on other physicians until this is cleared up. This makes a mockery of the regulatory process if he is involved."

Dr. Robert Kessler, a Boulder City physician, said, however, that asking Anwar to step down is "very premature."

"Like anybody else, he's innocent until proven guilty," he said. "We don't know that he did anything."

Goldsmith said that Anwar is part owner of Quality Care Consultants, a company that reviews policies and procedures of medical organizations and makes recommendations to meet national standards.

"He should have known what he was doing was wrong, given his expertise with Quality Care Consultants," Goldsmith said. "Even if he didn't do it himself, he should have spoken up and told his group that what they were doing was wrong."

Anwar is a friend of Dr. Dipak Desai, the owner of ambulatory surgery centers at the heart of the hepatitis C scandal. Anwar has recused himself from the board for any matters involving doctors at these clinics.

Goldsmith is under investigation by the Nevada Board of Medical Examiners for work he does with his TrimCare weight loss program.

In August, he received a letter contending the board had received information of illegal behavior, including illegally dispensing compounded medications, prescribing pain medication without proper diagnosis and using human growth hormone on patients without meeting FDA criteria.

Goldsmith, who professes his innocence, thinks he was singled out for investigation because of his criticism of Anwar and Desai, the former chairman of the board's investigative committee.

Anwar, president of the medical board from 2005 to 2008, came under fire from the public, Goldsmith, other doctors and state lawmakers when he did not summarily suspend Desai's medical license when the hepatitis outbreak became public.

Gov. Jim Gibbons asked Anwar to resign, but he refused.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.