McKnight’s reported that Rafael Chikvashvili, owner of Baltimore-based Alpha Diagnostics LLC, was convicted of two counts of healthcare fraud resulting in death, wire fraud, false statements and aggravated identity theft. He faces a maximum sentence of life in prison for each of the counts of healthcare fraud resulting in death. Separately, he faces up to 20 years on the other charges.
Chikvashvili created false radiology and ultrasound reports for patients, and submitted reimbursement claims for services that were never provided, or that Alpha was not licensed to provide. He also instructed non-physician employees to interpret X-rays, ultrasounds and cardiologic examinations and draft false physician reports. Chikvashvili would then forge a physician’s signature on the reports and submit them to Medicare.
Two patients died as a result of having their X-rays interpreted by unqualified Alpha employees, authorities say.
Alpha employees misinterpreted the chest X-ray of one nursing home resident with congestive heart failure, who remained at the facility instead of being transferred to a hospital for treatment. She died four days later. If she had been moved to a hospital, her life expectancy would have increased, witnesses said.
A second patient’s chest X-ray showed mild congestive heart failure, which raises the risk of bleeding during surgery. An Alpha employee failed to detect the heart failure on the patient’s X-ray, and the patient was cleared to undergo elective surgery. She experienced significant bleeding during and after the surgery, and died six days later.
Alpha Diagnostics submitted claims to Medicare for both patients, saying their X-rays had been interpreted by licensed radiologists. The company, which provided services in Maryland, Delaware, Pennsylvania, Virginia and the District of Columbia, defrauded Medicare and Medicaid out of $7.5 million between 1997 and 2013, authorities said.
“The evidence showed that Rafael Chikvashvili failed to provide medical services to patients who needed them, and billed for services that he did not provide,” U.S. Attorney Rod J. Rosenstein said in a news release.