New Charges Filed Against The Owner Of Alpha Diagnostics Including Four Counts Of Health Care Fraud Resulting In Death
Allegedly Defrauded Medicare and Medicaid of More Than $7.5 Million
Baltimore, Maryland - A federal grand jury has returned a superseding indictment against the owner of Alpha Diagnostics, Rafael Chikvashvili, age 67, of Baltimore, Maryland, adding four counts of health care fraud resulting in serious bodily harm and death, as well as conspiracy and wire fraud, related to a scheme to defraud Medicare and Medicaid of more than $7.5 million. The superseding indictment was returned late on April 9, 2015. No court appearance has been scheduled yet for Chikvashvili on the superseding indictment, and he continues on release under the supervision of U.S. Pretrial Services.
The superseding indictment was announced by United States Attorney for the District of Maryland Rod J. Rosenstein; Special Agent in Charge Nicholas DiGiulio, Office of Investigations, Office of Inspector General of the Department of Health and Human Services; and Special Agent in Charge Stephen E. Vogt of the Federal Bureau of Investigation.
According to the indictment, Chikvashvili formed Alpha Diagnostics Services, Inc., which later became Alpha Diagnostics, LLC, in 1993, and always acted as Managing Member, Authorized Official, Managing Employee, President and Chief Executive Officer for Alpha Diagnostics. Chikvashvili holds a PhD in mathematics, but was never a medical doctor or licensed physician. Timothy Emeigh was the Vice President in charge of Operations at Alpha Diagnostics. He was a licensed radiologic technologist.
Alpha Diagnostics was a portable diagnostic services provider, principally of X-rays, but also provided ultrasound tests, and cardiologic examinations. Alpha Diagnostics operated in Maryland, Delaware, Pennsylvania, Virginia and the District of Columbia. Alpha Diagnostics was headquartered in Owings Mills, Maryland, where Chikvashvili worked full time.
The 33-count superseding indictment alleges that beginning in 1997 through October 2013, Chikvashvili conspired with Timothy Emeigh and others to defraud Medicare and Medicaid by creating false radiology, ultrasound and cardiologic interpretation reports; by submitting insurance claims for medical examination interpretations that were never completed by licensed physicians; by falsely representing to Medicare and Medicaid, as well as to treating physicians, that the interpretations had, in fact, been completed by actual licensed physicians; and by submitting insurance claims for radiology, ultrasound and cardiologic examinations (and their associated costs) that were never performed, and/or which were in excess of the number of examinations ordered by the treating physician.
For example, in June 2012, Emeigh traveled to Jamaica for a vacation. The superseding indictment alleges that Chikvashvili directed Emeigh, through text messages and telephone calls, to view medical images using his personal laptop in his hotel room and then draft false physician interpretation reports. Alpha Diagnostics personnel subsequently submitted false claims to Medicare for these images and fraudulent physician reports.
The superseding indictment alleges that four patients died because their x-rays were not interpreted by a qualified radiologist. Instead, Alpha Diagnostics employees reviewed the images and failed to detect congestive heart failure, pneumonia, and a large pelvic mass revealed in the images. The patients suffered serious complications, and ultimately died. According to the indictment, had those images been correctly interpreted by a licensed radiologist, the medical treatment for those patients would have been different and/or their surgery avoided.
For example, on May 1, 2012, Alpha Diagnostics personnel took a chest X-ray of a patient who was scheduled to undergo elective surgery, to determine if the patient could safely have surgery. The indictment alleges that the image was not interpreted by a qualified radiologist but instead, a non-physician Alpha employee attempted to interpret the image. The employee reported the image as negative for any chronic conditions when in fact, the image revealed mild congestive heart. Based on the incorrect reading of the chest X-ray, the patient was cleared for the elective surgery, which resulted in significant complications and the worsening of the patient’s congestive heart failure. The patient died on May 7, 2012. The indictment alleges that, if the chest X-ray had been properly interpreted, the patient would not have been cleared for surgery and would not have died at that time. Subsequently, Alpha Diagnostics submitted a claim to Medicare falsely representing that a licensed radiologist had interpreted the patient’s chest X-ray. Medicare paid Alpha Diagnostics $218.36 for this claim.
Further, according to the superseding indictment, Chikvashvili and Alpha Diagnostics routinely submitted insurance claims to Medicare and Medicaid that, among other things, exaggerated the services performed by its technologists or exceeded the services ordered by the treating physician; overcharged for transportation costs; and falsely represented that Alpha Diagnostics was properly overseen by supervising physicians.
Finally, the superseding indictment seeks forfeiture of at least $7.5 million, including two properties, luxury vehicles, bank and investment accounts, and a safe deposit box.
Chikvashvili faces a maximum sentence of life in prison for the conspiracy and for each of four counts of health care fraud resulting in serious bodily harm and death; 10 years in prison for each of seven counts of health care fraud; 20 years in prison for each of eight counts of wire fraud; a maximum of five years in prison for each of 11 counts of false statements relating to health care matters; and a mandatory two years, consecutive to any other sentence imposed, for two counts of aggravated identity theft.
An indictment is not a finding of guilt. An individual charged by indictment is presumed innocent unless and until proven guilty at some later criminal proceedings.
Timothy Emeigh, age 51, of York Springs, Pennsylvania previously pleaded guilty to health care fraud and is awaiting sentencing.
United States Attorney Rod J. Rosenstein praised the HHS-OIG and the FBI for their work in the investigation. Mr. Rosenstein thanked Assistant United States Attorneys Leo J. Wise and P. Michael Cunningham, who are prosecuting the case.