State agency investigates PacifiCare
Friday, Aug. 7, 1998 | 3:38 a.m.
Two auditors from the division were at the company Thursday in Las Vegas examining the health maintenance organization's billing and claims records.
Guy Perkins of the division's life and health section, said a "thorough examination" is being conducted. He added the agency already has obtained well into six figures of claim payments for doctors.
Bob Lawrence, administrator of the Cardiovascular Center of Southern Nevada, said his group terminated its contract with PacifiCare in June because the insurer owed $1.3 million to doctors for services performed over the past year and a half.
PacifiCare had contracted with FPA, a medical management group that went bankrupt, and that's part of the problem, said Jennifer Sizemore, spokeswoman for PacifiCare.
PacifiCare is part of Santa Ana, Calif.-based PacifiCare Health Systems Inc., which reported that second-quarter profit more than doubled as the result of cost controls. Net income was $48.8 million, up from $18 million a year earlier.
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