South Bay surgery clinic firm sued for $39 million [San Jose Mercury News, Calif.]

June 18--A second insurance giant has sued Saratoga-based Bay Area Surgical Management and its five facilities, claiming that the company submitted inflated and fraudulent bills that cost the insurer more than $39 million.

The suit, filed Monday by United Healthcare Services, echoes assertions in an Aetna Insurance suit filed early this year that the company is making millions of dollars and enriching local doctors by sidestepping state laws meant to protect patients and control costs.

United claims that in one case Los Gatos's National Ambulatory Surgical Center billed United $69,700 for a single arthroscopic knee scope and repair -- more than nine times the average fee $5,853 billed by United's other Northern California providers.

Forest Surgery Center in San Jose billed United $32,300 for two spinal injections, compared to $1,535 at centers elsewhere, more than 1,785 percent higher than at the company's approved providers.

The suit also alleges a "kickback scheme" between Bay Area Surgical Management and its doctors. It says that the company recruited local doctors to invest in its outpatient facilities and then to refer patients to those facilities.

The insurers and nonaffiliated doctors say that consumers bear the burden of such overcharges, through surging health insurance premiums.

The co-founders and managers of Bay Area Surgical Management, named in the suit, are Julia Hashemieh, Bobby Sarnevesht and Javad

Zolfaghari.

--The outpatient surgery centers named in the suit are:

--Bay Area Surgical Group, Santa Clara

--Forest Surgery Center, San Jose

--Knowles Surgery Center, Los Gatos

--Los Altos Surgery Center, Los Altos, and

--National Ambulatory Surgery Center, Los Gatos

Return to this site to read more about this developing story.

Contact Lisa M. Krieger at 650-492-4098.

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