February 27, 2009

DOCTOR PLEADS GUILTY TO HEALTH CARE FRAUD FOR GIVING AIDS AND HIV PATIENTS DILUTED MEDICATIONS

A well-known AIDS doctor has pleaded guilty to federal fraud charges for "subdosing" patients by administering doses of medicine that contained less than the prescribed amount of medication that the patients were supposed to receive.

Dr. George Steven Kooshian , 58, of La Quinta, who operated Valley View Internal Medicine Group and Ocean View Internal Medicine Group at four locations in Los Angeles and Orange Counties, pleaded guilty Tuesday afternoon to two counts of health care fraud and two counts of making false statements relating to health care matters.

A co-defendant, Virgil Opinion, 49, of Anaheim, who was Kooshian's assistant for more than 10 years, previously pleaded guilty to participating in the scheme.

By pleading guilty, Kooshian specifically admitted that he and Opinion improperly billed patients' health insurance providers for medications used to treat problems relating to AIDS, HIV and hepatitis. The medications involved included Epogen, which is used to treat anemia; Interferon, which is used to treat Kaposi's sarcoma; and Immunogammaglobulin, which is used to treat peripheral neuropathy or numbness of the extremities. The false billings in this case included bills submitted 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. Kooshian admitted that health insurance providers, including Medicare, suffered losses of at least $350,000 in fraudulent claims relating to these medications, and the government has alleged that the losses could be as high as $660,955.

Kooshian is scheduled to be sentenced on May 11 by United States District Judge Alicemarie H. Stotler in Santa Ana. At sentencing, Kooshian faces a maximum statutory sentence of 50 years in federal prison, although his actual sentence will be determined by Judge Stotler.

Opinion is scheduled to be sentenced by Judge Stotler on May 4.

The case was investigated by the Federal Bureau of Investigation and the United States Department of Health and Human Services, Office of Inspector General.

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For more information on federal criminal defense law, contact the Law Offices of Joseph Shemaria of Los Angeles, California.