21 July – LAWFUEL – The Law News Network – A well-known AIDS doctor and his back office assistant were indicted today on charges of “subdosing” patients, that is, administering to a patient a dose of medicine that contained less than the prescribed amount of medication that the patient was supposed to receive.
George Steven Kooshian , 54, operated Valley View Internal Medicine Group and Ocean View Internal Medicine Group at four locations in Los Angeles and Orange Counties. Virgil Opinion, 45, was Dr. Kooshian’s back office assistant for more than ten years.
The indictment charges Dr. Kooshian and Opinion with conspiracy, twenty-five counts of health care fraud, and three counts of making false statements relating to health care matters.
Specifically, the indictment alleges that Dr. Kooshian ordered Opinion and other employees to subdose patients who were suppose to be receiving certain medications to treat problems relating to AIDS, HIV and Hepatitis. The medications involved were: Epogen, used to treat anemia; Interferon, used to treat Kaposi’s sarcoma; and Immuno gammaglobulin (“IVIG”), used to treat peripheral neuropathy or numbness of the lower extremities. According to the indictment, the patients received one half to one quarter of the dose they were supposed to receive of these medications, or only saline or water.
The indictment further alleges that Dr. Kooshian improperly billed patients’ health insurances for these medications, including: billing for a full dose of the medication when the patient was subdosed; continuing to bill for administering the medication when the patient was no longer taking it; and billing as if the medication had been administered in the office by medical personnel when the patient had been self-injecting the medication at home.
All in all, the indictment alleges that Dr. Kooshian bilked health insurance companies, including Medicare, out of approximately $1.2 million in fraudulent claims relating to these medications.
The investigation into Dr. Kooshian’s activities started when Opinion terminated his employment with Dr. Kooshian and came forward to the press, claiming “his conscience was killing him” in connection with the subdosing of patients. Opinion, as well as a former patient of Dr. Kooshian’s who was subdosed, subsequently sued Dr. Kooshian civilly. The civil suit was settled pursuant to a confidential settlement agreement.
An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty beyond a reasonable doubt.
Dr. Kooshian and Opinion will be summoned to appear for an arraignment next month in United States District Court in Santa Ana. If convicted, Dr. Kooshian and Opinion face statutory maximum sentences of 10 years in federal prison for each of the 25 health care fraud counts, and 5 years in federal prison for the conspiracy and each of the false statements relating to health care matter counts, although their actual sentence will be determined by a United States District Judge.
The case was investigated by the Federal Bureau of Investigation and the United States Department of Health and Human Services, Office of Inspector General.
CONTACT: Assistant United States Attorney Jeannie M. Joseph