Vice President of X-Ray Company Sentenced to Four Years in Federal Prison for Health Care Fraud
Defendant Falsely Claimed Physicians and Radiologists Interpreted X-rays and Other Tests; Scheme Endangered Patients and Cost Medicare Over $2.5 Million in Losses; Company President to Serve 10 Years for Causing Patient Deaths
Baltimore, Maryland – U.S. District Judge James K. Bredar sentenced Timothy Emeigh, age 52, of York Springs, Pennsylvania today to four years in prison, followed by one year of supervised release, for health care fraud arising from a scheme in which insurance providers and Medicare were fraudulently billed for tests interpreted by unlicensed personnel, and for tests and services which in fact had not been provided.
The sentence 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 Kevin Perkins of the Federal Bureau of Investigation.
According to his plea agreement, Emeigh was a licensed x-ray technologist in Maryland. Emeigh was not a licensed physician. Emeigh worked at Alpha Diagnostics Services beginning in 1993 as an x-ray technologist. In 1997, he was named vice president of the company’s operations by Rafael Chikvashvili, the CEO and owner of Alpha Diagnostics.
Alpha Diagnostics was principally a portable x-ray supplier in Maryland, Delaware, Pennsylvania and Virginia. However, Alpha Diagnostics also supplied or provided portable ultrasound tests, electrocardiograms (“EKGs”), echocardiograms and Holter monitors. The majority of its clients were nursing homes, whose patients Alpha Diagnostics tested. Alpha Diagnostics was headquartered in Owings Mills, Maryland with an office in Harrisburg, Pennsylvania. Alpha Diagnostics was enrolled in the Medicare program. Medicare required that a licensed physician order and interpret the x-ray or other test, and render a formal report.
Nonetheless, in 1997, at Chikvashvili’s request, Emeigh began performing x-ray interpretations in lieu of a licensed physician or radiologist, and producing fraudulent reports using the names of actual physicians who had never seen the x-rays in question. In 2003, as technology improved, Emeigh began interpreting medical tests and writing reports in the name of registered licensed physicians from his home using his home computer. In addition to x-rays, Emeigh began interpreting and drafting fraudulent reports for ultrasounds and EKGs from his home, while traveling out of state, and at times, from overseas. Sometimes Emeigh performed medical interpretations and transmitted x-ray images using a cell phone application. Emeigh maintained steady communication with Chikvashvili regarding the interpretation reports that he created from remote locations.
By 2010, Emeigh performed more than 70% 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.
Emeigh suggested to Chikvashvili that he transmit particularly difficult medical interpretations to actual licensed physicians. If a patient caregiver contacted Alpha Diagnostics to question any of the medical interpretation reports generated by Emeigh or other unlicensed Alpha Diagnostics personnel, Emeigh and Chikvashvili reassigned the diagnostic interpretation to an actual licensed physician for a second interpretation, who was not apprised of the first interpretation and conclusion.
Alpha Diagnostics would bill insurance providers for 2-view chest x-rays even where single-view x-rays had been ordered or performed. 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. 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.
From January 2007 through October 2012, the financial loss to Medicare alone for the misconduct described above was more than $2.5 million.
The owner of Alpha Diagnostics, Rafael Chikvashvili, age 69, of Baltimore, Maryland, was sentenced on June 15, 2016, to 10 years in prison, followed by two years of supervised release, for charges related to a health care fraud and wire fraud conspiracy resulting in the deaths of patients, as well as false statements and aggravated identity theft, related to a scheme to defraud Medicare and Medicaid of more than $6 million. Chikvashvili was convicted by a federal jury on February 17, 2016.
United States Attorney Rod J. Rosenstein praised the HHS- Office of Inspector General and FBI for their work in the investigation, and thanked Assistant U.S. Attorneys Leo J. Wise and P. Michael Cunningham, who prosecuted the case.