A healthcare provider has been sentenced to 10 years in prison for more than $20 million in healthcare fraud that also resulted in patient deaths.
Rafael Chikvashvili, 69, owned Alpha Diagnostics, a company that provided portable X-rays and other examinations to patients primarily in nursing homes and retirement communities in the Maryland area.
For nearly 20 years, Chikvashvili conspired with others to defraud Medicare, Medicaid and other insurers by creating false radiology reports that were never ordered. He did, however, order non-physician employees to interpret X-rays instead of sending them to licensed physicians. According to court testimony, that resulted in at least two patient deaths.
“This was an unusual case,” says Special Agent Keith Custer, who led the investigation from the FBI’s Baltimore Division in an agency press release. “Most healthcare fraud that results in injury or death happens when providers illegally bill for unnecessary procedures. This case wasn’t about providing unnecessary care, it was about denying people the care they desperately needed and deserved.”
Two Alpha Diagnostics employees contacted authorities in 2013 alleging the company was uploading and that non-physician co-workers were performing interpretations and fraudulently using real doctors’ names. The FBI and U.S. Department of Health and Human Services Office of Inspector General investigated the claims.