A High Desert physician remains in federal custody today after his arrest Wednesday on charges of illegally dispensing prescriptions for often-abused controlled substances – including opioid-based medications – during telemedicine sessions with “patients” from across the United States.
Dr. Raphael Tomas Malikian, 36, who resides in Llano and Palmdale and called his medical practice Happy Family Medicine, was arrested Wednesday afternoon by special agents with the Drug Enforcement Administration.
An indictment naming Malikian was unsealed at his arraignment Thursday evening, when Malikian entered not guilty pleas and a United States Magistrate Judge ordered him detained pending trial, which is currently scheduled for October 5.
Malikian is charged in an 11-count indictment with illegally distributing narcotics “while acting and intending to act outside the usual course of professional practice and without a legitimate medical purpose.” The controlled substances that Malikian allegedly distributed are oxycodone, hydrocodone, alprazolam, promethazine and codeine.
The DEA investigation was prompted by multiple reports in February 2020 of suspicious prescriptions issued by Malikian. The indictment alleges specific incidents in which Malikian prescribed controlled substances without a medical purpose after seven telemedicine consultations – including one conducted entirely via text message – starting in April 2020 and continuing through July 2020. None of the consultations involved any physical exam or diagnostic tests, and the appointments lasted as little as 2 minutes and 20 seconds.
A federal judge on Thursday unsealed search warrants executed at Malikian’s residences in conjunction with his arrest. The affidavit in support of the search warrants outlines the DEA’s investigation, which included various undercover operations in which agents from the DEA and California DOJ posed as patients and received the prescriptions that form the basis of the indictment. The DEA agent who authored the affidavit concluded that Malikian “effectively sells prescriptions for controlled substances to patients upon request, and does so without obtaining a patient’s medical history or conducting a physical examination.”
According to the affidavit, an independent medical expert reviewed the interactions between Malikian and the undercover agents and “concluded that Malikian ‘did not thoroughly evaluate his patients’ before prescribing ‘potent and potentially deadly medications,’ and had done so ‘without any regard to what is required of conscientious physicians in the United States before proceeding with controlled medications.’”
A DEA investigator also reviewed patient records maintained by Malikian, which showed that Malikian saw patients across the United States and that about 43 percent of them shared common addresses, email addresses, “caregivers” or phone numbers with other patients. According to the affidavit, one of those patients was a convicted narcotics trafficker and another was stopped at Los Angeles International Airport while carrying over $19,000 in cash and approximately 1,764 Hydrocodone and Alprazolam pills.
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.
The charges alleged in the indictment carry different statutory maximum sentences. Seven of the counts allege the illegal distribution of opioids, such as oxycodone, and those charges carry a maximum possible penalty of 20 years in federal prison.
The DEA is conducting an ongoing investigation in this case. The California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse provided substantial assistance.
Assistant United States Attorney Marina A. Torres of the International Narcotics, Money Laundering, and Racketeering Section is prosecuting this case.
Tags: Alprazolam Healthcare Fraud Hydrocodone Opioid Crisis Oxycodone Patient Harm Pill Mills Promethazine Provider Arrest Rx Fraud Telemedicine