California: AIDS Doctor Admits to Health Care and Insurance Fraud

A physician who saw HIV/AIDS patients in Los Angeles and Orange counties admitted in federal court Thursday to diluting medications and falsely billing patients' health insurers. In exchange for pleading guilty to four counts of billing fraud and making false health care statements, 29 other counts relating to the scheme, which lasted roughly from 1995 to 2001, were dropped.

Dr. George Steven Kooshian operated Valley View Internal Medicine Group at two sites in Garden Grove as well as the Ocean View Internal Medicine Group in Laguna Beach and Long Beach.

Problems surfaced in 2001 when a former medical technician, Virgil Opinion, alleged the administration of watered-down medications in an article in OC Weekly. That prompted an investigation by the FBI and US Health and Human Services. Opinion pleaded guilty to participating in the fraud. In 2005, the US attorney's office charged Kooshian with health care fraud, conspiracy, and making false statements to insurance companies.

The medications involved were treatments for HIV/AIDS and hepatitis, including Epogen for anemia; interferon for Kaposi's sarcoma; and intravenous immune globulin for numbness in extremities. Kooshian was billing health insurers for full doses. In 2000, Kooshian told one patient he was receiving IV immune globulin, but the injection contained only vitamins and saline. The bills in question amounted to at least $350,000.

One of Kooshian's attorneys, William Kopeny, noted both prosecutors and defense agreed that "a failure to provide a full dose of these medications would not necessarily shorten the life or cause the death of a patient." "I believe no harm was done to any patient," Kopeny said. The 50-year maximum sentence for Kooshian's offenses will probably be reduced because of his admission of guilt, said Lawrence E. Kole, assistant US attorney.

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