Former doctor Raphael Tomas Malikian has been sentenced to 37 months in federal prison for his involvement in an illicit telehealth prescribing scheme. Operating under the guise of Happy Family Medicine, Malikian utilized telehealth services via telephone and text messages to issue prescriptions for controlled substances, including opioid-based medications, without adhering to proper medical protocols. According to the United States Attorney’s Office for the Central District of California, Malikian’s illegal activities spanned from December 2019 to August 2021. During this period, he prescribed medications without conducting proper medical assessments, obtaining patients’ full medical histories, or performing necessary physical examinations. Malikian also failed to verify the identities of individuals before issuing controlled substance prescriptions, facilitating fraudulent activities within his practice. Malikian collaborated with co-conspirators who provided false identities, allowing him to prescribe medications under fraudulent pretenses. These prescriptions were subsequently filled and resold on the black market, supporting opioid misuse and contributing to the country’s ongoing opioid crisis.
The severity of Malikian’s actions is outlined by instances where he prescribed large quantities of opioids without legitimate medical justifications. Notably, Malikian issued prescriptions to undercover law enforcement officers without conducting proper evaluations or verifying their identities, highlighting the egregious nature of his fraudulent practices. In October 2023, Malikian pleaded guilty to charges of aiding and abetting the acquisition of a controlled substance by fraud and distribution of oxycodone. He was sentenced to prison and ordered to pay a fine of $20,000, reflecting the gravity of his offenses and their detrimental impact on public health. This sentencing comes amid heightened scrutiny of telehealth prescribing practices, particularly in light of regulatory flexibilities introduced during the COVID-19 pandemic. While telemedicine offers convenience and accessibility, concerns regarding its potential misuse have prompted regulatory agencies to reevaluate prescribing guidelines for controlled substances.
The Drug Enforcement Administration (DEA) initially proposed ending pandemic-era exceptions that allowed virtual prescribing of Schedule II controlled substances without prior in-person examinations. Stakeholders within the healthcare industry advocated for maintaining these flexibilities, citing the importance of telemedicine in providing necessary care to patients. Despite the benefits of telehealth, there are legitimate concerns regarding its potential for facilitating illicit prescribing practices. As evidenced by Malikian’s case, lax oversight and inadequate verification procedures can enable individuals to exploit telehealth platforms for personal gain, endangering patient safety and contributing to substance misuse.
Moving forward, regulatory agencies must find a balance between promoting telemedicine’s accessibility and safeguarding against fraudulent activities. Implementing strict verification protocols and ensuring adherence to established medical standards are necessary steps in preventing similar schemes from developing in the future. The sentencing of Raphael Tomas Malikian serves as a reminder of the dangers posed by illicit telehealth prescribing schemes. By holding perpetrators accountable and implementing strict regulatory measures, authorities can mitigate the risks associated with telemedicine while preserving its potential to enhance healthcare delivery.
