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||Daily Trial Facts
- The Health Plan of Nevada Gambled With The Lives of Nevada Families.
- The Health Plan of Nevada dropped Dr. Desai because of complaints about the quality of care and hired him back years later because he gave an extraordinarily low bid.
- "We will prove that the Health Plan of Nevada knew what was going on at the clinics, they knew about the practices of the doctors and did nothing," Robert Eglet, attorney for the plaintiffs.
- "The Health Plan of Nevada took billions in insurance premiums from Nevada families. The HMO is responsible for the doctors they require patients to use," said Robert Eglet
- $15 billion in premiums were paid to the Health Plan of Nevada by Nevada families from 1997- 2007. The Health Plan of Nevada collected $1.8 billion from Clark County families in 2012.
The Chief Epidemiologist for the
Southern Nevada Health District says
that his investigation of the Clinic
immediately documented dozens of
dangerous procedures by staff. He agrees
that Health Plan of Nevada could have
easily found the same problems with even
a cursory site visit. (Click here to
read Labus testimony)
The Chief of Gastroenterology at the
largest hospital in Nevada states that
he was so concerned that Health Plan of
Nevada would re-hire Dr. Desai that he
personally drove to their corporate
office and told them about 33 cases of
billing fraud, 5 cases of medical
malpractice and 1 case where Desai
altered hospital records to conceal his
malpractice. He states that his warnings
were ignored and could have prevented
the entire hepatitis outbreak. (Click
here to read Dr. Cohan testimony)
A former employee at Health Plan of
Nevada's surgery center says that Dr.
Desai did rushed and shoddy operations
there for years before starting his own
Clinic. He confirms that the surgery
center repeatedly scheduled Dr. Desai to
operate on 20 patients in just 3 hours
(9 minutes each operation) when all
experts agree that colonoscopies should
be done in over 30 minutes. He confirms
that Health Plan of Nevada management
was directly and repeatedly alerted to
these serious risks but did nothing.
(Click here to read Hawkins testimony)
A former employee at Health Plan of
Nevada's surgery center documents
operation where Dr. Desai jerked out the
colonoscope so rapidly that feces
splattered on the operating room
ceiling. The feces is left there for
days and causes numerous employees to
complain to management that Dr. Desai
needs to be terminated. (Click here to
read Hawkins testimony)
A former employee at Health Plan of
Nevada's surgery center states that
Senior Executives refused to allow their
family members to be treated by the
cheaper doctors that members were forced
to use. He documents one case where the
Chairman of the Quality Committee
demanded that a competant (but more
expensive) gastroenterologist be brought
in to operate on his wife because she
refused to allow the incompetent Dr.
Desai to touch her. (Click here to read
The expert hired by the Health Plan of
Nevada admits that a reasonable HMO
should not hire doctors that will
jeopardize the safety of its patients
and should not hire a doctor just
because he submits the cheapest bid.
Health Plan of Nevada contracts with Dr.
Desai anyway. (Click here to read
A doctor member of the Committee that approved Dr. Desai as supposedly a “high-quality” doctor admits that he would not vote again for approval if Health Plan of Nevada had revealed that Desai was doing the fastest colonoscopies in the United States (2 to 3 minutes) when the national average is 30 minutes for this screening procedure. He also admits that the hundreds of false billings of 31 minutes for these 2 or 3 minute operations would automatically disqualify the applicant. See Manning February 28, 2013 Testimony.
A nurse member of the Committee that approved Dr. Desai as supposedly a “high-quality” doctor confesses that Dr. Desai should never have been approved given either the investigation by Dr. Charles Cohan or the dozens of prior medical malpractices cases against Desai. She also agrees that the 2 to 3 minute quicky colonoscopies by Desai should have caused in disapproval by itself. See Kinard March 1, 2013 Testimony.
A doctor member of the Committee that approved Dr. Desai as supposedly a “high-quality” doctor admits knowing as early as 2000 that Dr. Desai bragged about doing the fastest colonoscopies in the United States – two years before Health Plan of Nevada contracted with Desai in 2002. He also states that the Committee that approved Desai was not told of the comphrensive investigation by Dr. Cohan of Desai’s misdeeds but should have been. This doctor continues to say that Health Plan of Nevada should have also told the Committee about the 22 medical malpractice cases against Dr. Desai but did not do so. See March
1 2013 Coquit Testimony.
The competent gastroenterologist that Health Plan of Nevada fired in 1999 to re-hire Dr. Desai confirms that it was generally known in the medical community in the 1990's that Dr. Desai was performing colonoscopies at the amazing speed of 5 minutes or less (“Everybody knew it.”)
He also says that the number of these lightning fast colonoscopies in 3 hours (20 operations in one room) or in an entire day (100 operations in two rooms) could not have been correctly done by “Superman” and that, by way of comparison, only 64 colonoscopies each week are done at the entire UCLA medical facility. See March 1, 2013 Fayad Testimony.
Health Plan of Nevada fired Dr. Desai in 1993 because of multiple serious quality of care problems Desai inflicted on their patients at Nevada hospitals. From 1993 to 1999, Dr. Fayad takes over the entire Health Plan of Nevada gastroenterology contract and there are no problems with Fayad’s excellent care of patients. In 1999, the President of Health Plan of Nevada (“Bunker”) calls Fayad and presents him with a take it or leave it offer to either match an extremely low bid from Dr. Desai or lose the entire contract. Dr. Fayad refuses – informing the President that it would be impossible to take care of the patients at this cut rate unless Desai unreasonably cut costs or increased patient volume. Health Plan of Nevada has a stormy Executive Committee meeting where the Medical Quality Director (Dr. Ebbin) insists that Desai be avoided at all costs because of Desai’s horrible care but the President orders that Desai be given the contract to save money. See March 1, 2013 Fayad Testimony.
The former head of contracting
confirms that Health Plan of Nevada was
very satisfied with the excellent
service provided by Dr. Fayad from 1993
to 1999 but decided to send out a
request for proposal for the
gastroenterology contract to save money.
She confirms that an HMO Special
Committee including herself, HPN
President Bunker, the Doctor Quality
Director and another doctor met and that
the “prized” contract was taken from Dr.
Fayad because he was not the low bidder.
She also admits that Dr. Desai’s per
colonoscopy rate was so low at $294 per
screening colonoscopy that Medicare was
paying much more at $459 for the exact
same procedure and that a normal HMO
rate should have been $588 per
procedure. At 10,000 operations a year,
this meant that HPN only had to pay Dr.
Desai $2.94 Million dollars a year while
Medicare would hve paid $4.59 Million
dollars a year and a normal HMO rate
would have been $5.88 Million dollars a
year. She describes the $3 Million a
year that Health Plan of Nevada saved
through Desai’s bargain basement rate as
“a good day for HPN.” See March 4, 2013
The premier HMO expert in the United
States describes how he has testified
before Congress repeatedly, published,
lectured, and produced an upcoming CNN
documentary on HMOs. He explains that
Health Plan of Nevada got five direct
financial benefits from the cutrate it
negotiated with Dr. Desai for
colonoscopies: (1) the HMO reduces is
costs by having a low doctor payment
rate; (2) the HMO can “buy” new business
by offering predatory health insurance
rates since it has an extraordinary low
cost of business; (3) the new business
allows the HMO to increase its market
share; (4) having more market share
allows the HMO to negotiate discount
rates with other doctors and hospitals,
further lowering its cost of business;
and (5) after it becomes the dominant
HMO in the community, the HMO can raise
insurance premiums much faster than the
national average. The expert observes
that Health Plan of Nevada doubled its
membership from 199,000 to 400,000
during the 7 years it contracted with
Dr. Desai (1999-2007) and states that
this is an unprecedented achievement for
an HMO. The expert explains how saving
$3 Million a year on what it paid Dr.
Desai on the extraordinary low
colonoscopy payment rate (compared to
the much higher hypothetical rate that
national models would predict) allowed
the HMO to increase its market share to
the point of over 80% of the HMO market
in Las Vegas. See March 5, 2013 Potter
was a member of the Credentialing
Committee. He said that HPN should
have given him the Cohan information and
that, if told about the Cohan
information, that persons should not
have gone to Dr. Deai or ECSN. See
March 18, 2013 Pierce testimony.
Dr. Muthialu testified that she was a
member of the Credentialing Committee
and that, in a typical year, HPN did
on-site inspections of twenty different
surgical centers. But HPN admits
that HPN failed to inspect ECSN at any
time from 1999 to 2007. Dr.
Muthialu also says that HPN should have
given her the Cohan information and
that, if told about the Cohan
information, neither Dr. Desai or ECSN
should have been approved. See
March 18, 2013 Muthialu testimony.
Dr. Evans is an anethesiologist who was
HPN's Chief Medical Director and third
highest ranking employee. He admitted
personally giving anethesia for hundreds
of fast colonoscopies by Dr. Desai and
knowing that Dr. Desai did "15 to 20 in
an afternoon" and knowing "how long it
took him (Dr. Desai) to do operations."
Dr. Evans concedes that ten minutes is
the shortest possible time period
feasible to do an adequate screening
colonoscopy. When confronted with
the fact that the 20 colonoscopies in
just 3 hours that Dr. Evans admittedly
saw Dr. Desai perform for years averaged
out to just nine minutes per
colonoscopy. (well under the ten minute
shortest possible operation time), Dr.
Evans admits that HPN should have been
"concerned" about Dr. Desai's overly
rapid operations. See March 19,
2013 Evans testimony.
Dr. Gex as employed as an
anethesiologist by HPN and sent to work
at ECSN. He admits giving
anethesia for 18 operations in just one
day at ECSN and that it was very unusual
("atypical") for a gastroenterologist to
do such hasty colonoscopies. See
March 20, 2013 Gex testimony.
Dr. Ebbin was the former President of
HPN's surgery center and the current
Vice President of HPN's Doctor Quality
Department. He admits that he sent
his wife to the competent
gastroenterologist that HPN terminated
in 1999 (Dr. Fayad) for NINE
colonoscopies, including mu7ltiple
colonoscopies during the EIGHT years
that Dr. Desai was HPN's designated
gastroenterologist. See March 20,
2013 Ebbin testimony.
John Bunker was the President of HPN
from 1994 to 2010. Bunker admits
that Defendants withheld $210 Million in
budgeted payments to doctors in 2003,
2004 and 2005 and kept the money for
itself. Bunker agrees that HPN
could have hired an additional 1,400
doctors with the $210 Million of the
doctor budget that HPN instead took for
additional executive compensation and
shareholder profits and admits that
1,400 more doctors would have
dramatically improved medical care for
HPN members. See March 21, 2013
||Robert Eglet, trial attorney for the plaintiffs, during opening statements in Las Vegas hepatitis C trial for role of Health Plan of Nevada in largest hepatitis C outbreak in U.S. history. Eglet tells jurors he will prove the HMO knew about the practices of the doctors and clinics and did nothing even though they knew it was dangerous for Nevada families.
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