Fraud Case Filed Against Doctor

A doctor who operated clinics in Orange and Los Angeles counties was indicted by a federal grand jury Wednesday on charges of deliberately underdosing his AIDS patients and billing insurance companies for the full amount of the expensive medications.

Dr. G. Steven Kooshian, 54, was accused of administering half or quarter doses, or substituting saline solutions, to patients with AIDS and HIV.

“We can’t say with any certainly that what he did caused anyone’s death, but it certainly affected his patients’ quality of life,” said Assistant U.S. Atty. Jeannie M. Joseph, who is prosecuting the case.

The medications were prescribed to treat problems related to acquired immune deficiency syndrome, HIV and hepatitis. They included Epogen for anemia, interferon for Karposi’s sarcoma and immunogammaglobulin for numbness of the legs and feet.

Kooshian, who had offices in Garden Grove, Laguna Beach and Long Beach, was charged with 29 counts of healthcare fraud, conspiracy, and making false and deceptive statements to insurance companies. He also was accused of billing insurance companies for medications after patients had stopped seeing him.

The indictment also said he bilked insurance companies and Medicare out of $1.2 million between 1995 and 2001.

Kooshian could not be reached for comment, but a receptionist at the Garden Grove office said he stopped practicing in September. His lawyer also could not be reached.

In 1991, Kooshian was arrested on charges of prescribing drugs, including anabolic steroids, to individuals who were not his patients, a California Medical Board official confirmed.

The state felony charges were reduced to misdemeanors, allowing Kooshian to keep his medical license. He pleaded guilty, was sentenced to three years’ court probation and paid a $20,000 fine.

The medical board also placed him on probation. According to official records, he told the agency he was “ashamed and humiliated by the realization of his unprofessional conduct.”

Also charged Wednesday was Kooshian’s former medical technician, Virgil Opinion, 45, who went public with the allegations against the doctor in an interview with the O.C. Weekly newspaper in 2001. Opinion’s statements triggered an investigation by the FBI and the U.S. Department of Health and Human Services, and led to the federal indictment.

While acknowledging that Opinion had blown the whistle on Kooshian, Joseph said the technician was criminally culpable because he participated in the scheme for several years, underdosing patients and preparing the fraudulent insurance company documents.

Opinion and a former patient brought civil suits against Kooshian in Orange County Superior Court. Their cases were resolved with confidential settlements, Joseph said.

Eric Lampel, who represented Opinion in his suit, said his client passed up several opportunities to negotiate a deal with prosecutors in the criminal case.

“He just didn’t seem to understand the seriousness of his situation,” Lampel said. “It’s really a shame because Virgil has suffered a lot. Working for Kooshian drove him to a nervous breakdown.”

In his lawsuit, Opinion said that Kooshian frequently directed him to inject patients with saline instead of the expensive prescription drugs they were told they were receiving.

When he complained about the practice, Opinion said, Kooshian threatened to “destroy” him if he went to authorities about it, vowing that Opinion “would never work in the medical field in California again.”

Opinion, who said he holds a medical degree from a university in the Philippines, continued working for Kooshian, fearing for his job and personal welfare, according to his lawsuit.

But he began to suffer bouts of severe anxiety and uncontrollable crying spells, and was unable to sleep and eat because of the abusive working conditions, he said. In 2001, Opinion quit.

In another lawsuit, Bryan K. Noble, a former patient, said he went to Kooshian for treatment in 1999. He said he was supposed to receive immunoglobulin injections but learned later that the doctor had substituted saline for the medication, placing him at “grave risk for bodily harm and/or death.”

Times staff writer Mai Tran contributed to this report.