LAS VEGAS (AP) - The FBI is investigating possible Medicare fraud at a Las Vegas surgical center believed to have spread hepatitis C by reusing syringes and vials of medication.

The Endoscopy Center of Southern Nevada also is under investigation by state officials for possible insurance and Medicaid fraud.

A top local health official alerted Nevada Rep. Jon Porter to the federal probe a week ago, Porter spokesman Matt Leffingwell said Friday.

At issue is whether the surgical center may have billed the federal Medicare program for 30-minute appointments that did not last that long, Leffingwell said.

The bureau does not comment on open investigations. The Southern Nevada Health District said it would not confirm the conversation between the congressman and its chief, Dr. Lawrence Sands, for the
same reason.

Six cases of acute hepatitis, a potentially deadly virus that attacks the liver, have been traced to the center. Nearly 40,000 patients have been notified that they are at risk and should be tested for hepatitis B and C and HIV.

The clinic has been temporarily closed and fined $3,000.

Health officials believe the virus was spread when clinic nurses used the same syringe twice to administer anesthesia, contaminating the vial. The staff also was found treating multiple patients with vials of medication intended for a single patient only.

Five of the six people infected received treatment at the clinic on the same day.

A spokeswoman for Nevada Attorney General Catherine Cortez Masto
said the office is investigating whether the practices may have resulted in insurance or state Medicaid fraud.

"We looking at whether they billed for two vials and only used one," spokeswoman Nicole Moon said.

The owner of the clinic, prominent gastroenterologist Dipak Desai, has refused to answer questions about the outbreak.

The state regulatory agency in charge of inspections at outpatient clinics has begun reviewing all other ambulatory surgical centers in the state and turned up several infractions.

As of Thursday, 13 centers had been inspected and syringe and vial reuse was observed by state surveyors, Lisa Jones, head of the state licensing bureau, told a legislative committee.

The bureau has been criticized for falling behind on its inspection schedule. The Endoscopy Center had not received a full inspection since December 2001, despite a bureau policy of inspecting ambulatory surgical centers every three years.

Jones says the bureau is understaffed.

Republican Gov. Jim Gibbons on Thursday urged the state health division to use all resources needed to complete a thorough review
of all centers in the state. Gibbons also made disaster funds available.

The review is expected to take a month.

"We are facing a public health crisis not only in the sense of certain facilities not adhering to commonsense medical practices and thus placing patient safety in jeopardy, but also the perception from the general public that it is not safe to have procedures done that help save lives, namely a colonoscopy exam," Gibbons said in a statement.

(Copyright 2008 by The Associated Press. All Rights Reserved.)