A Maryland healthcare provider has been sentenced to 10 years in federal prison for fraud that included patient x-rays that were not reviewed by a radiologist, the U.S. Department of Justice (DOJ) announced.
U. S. District Judge James K. Bredar sentenced Rafael Chikvashvili, owner of Alpha Diagnostics in Baltimore, for charges related to healthcare fraud and wire fraud conspiracy that resulted in the deaths of patients, as well as for false statements and aggravated identity theft that defrauded Medicare and Medicaid of more than $6 million.
Alpha Diagnostics was a portable diagnostic services provider, principally of x-rays, but also of ultrasound tests and cardiologic examinations. Its clients included nursing homes whose patients were covered by Medicare and Medicaid, according to the DOJ.
A jury found that from 1997 through October 2013, Chikvashvili created false radiology, ultrasound, and cardiologic interpretation reports; submitted insurance claims for medical examination interpretations that were never completed by licensed physicians; falsely claimed the interpretations had been done by actual licensed physicians; and submitted insurance claims for radiology, ultrasound, and cardiologic examinations that were never performed and/or were not ordered by a treating physician.
Two patients died of congestive heart failure because their x-rays were not interpreted by a qualified radiologist, according to the DOJ.
Judge Bredar also ordered that Chikvashvili pay restitution and forfeit proceeds of the fraud, the DOJ said.
