PacifiCare Nevada Division Under Audit

Business practices of a PacifiCare Health Systems unit in Nevada are being examined by that state’s insurance division following complaints from physician groups that they’re not being paid for services. Two auditors from the insurance division were at the company Thursday in Las Vegas, examining the health maintenance organization’s billing and claims records. Bob Lawrence, administrator of the Cardiovascular Center of Southern Nevada, said his group terminated its contract with PacifiCare of Nevada 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, a unit of PacifiCare Health Systems in Santa Ana.