It could be life in the slammer for Maryland portable diagnostics service provider Alpha Diagnostics owner Rafael Chikvashvili, Ph.D., after a jury found him guilty of health care fraud in the deaths of two patients.

"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," Rod J. Rosenstein, U.S. Attorney, said in a statement.

Alpha Diagnostics supplied portable X-ray services, ultrasound, electrocardiograms and Holter monitor studies mostly to nursing homes in Maryland, Delaware, Pennsylvania and Virginia.
In 1997, Timothy Emeigh, a licensed X-ray technologist in Maryland who worked at Alpha, was named vice president of its operations. He had also previously pleaded guilty to beginning at that time to create fraudulent X-ray reports that had not been interpreted by a licensed physician, as required.

"By 2010, Emeigh performed more than 70 percent of the X-ray interpretations, masquerading as a licensed radiologist or physician. On an average month, more than 1,000 X-ray interpretations were conducted by Alpha Diagnostics in Maryland alone," according to an FBI statement.

The scheme generated $7.5 million between 1997 and 2013 in fraudulent Medicare and Medicaid payments through a conspiracy in the creation of the bogus radiology, ultrasound and cardiologic reports.

"Alpha Diagnostics routinely submitted insurance payment claims which exaggerated the number of anatomical views performed by its X-ray and ultrasound technologists; and for multiple transportation charges on occasions when multiple patients had been examined at the same facility," noted the FBI report announcing Emeigh's 2014 guilty plea.

In addition, that report states Alpha Diagnostics would routinely bill Medicare for “global” X-ray procedures (i.e., both professional and technical components), along with transportation and setup charges, for studies interpreted “in-house” by Emeigh or other unlicensed Alpha Diagnostics personnel.

Emeigh is now awaiting sentencing after having testified at Chikvashvili's trial, according to the Maryland U.S. Attorney’s Office.

These unqualified interpretations by non-doctor workers, on the instructions of Chikvashvili, led to the two patient deaths. In one, congestive heart failure was missed and the patient did not receive timely acute care and died.

A second patient's pre-op X-ray was misread by a non-doctor and the patient was cleared for surgery when she should not have been. She then had significant bleeding during the operation and died.

"The jury found that two patients died because their X-rays were not reviewed by a qualified radiologist. Health care fraud has consequences, in money wasted and lives lost," said Rosenstein.

Chikvashvili could do life in prison for each of the two health care fraud counts that led to deaths and up to 20 years each for his other convictions, which include wire fraud conspiracy, making false statements and aggravated identity theft.

But Chikvashvili's lawyer Jonathan Biran told the Baltimore Sun that his client "is disappointed with the verdict, but he respects the process and will pursue an appeal."

Chikvashvili holds a Ph.D. in mathematics, but was never a medical doctor or licensed physician, according to the U.S. Attorney's office.

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