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Healthcare CEO Faces Life in Prison for Fraud That Led to 2 Patient Deaths

Healthcare CEO Faces Life in Prison for Fraud That Led to 2 Patient Deaths

By Ayla Ellison for Becker’s Hospital Review

The CEO and co-owner of a Maryland diagnostics company is facing life in prison after a federal jury convicted him of two counts of healthcare fraud that resulted in death, according to the Department of Justice.

On Wednesday, a federal jury found 67-year-old Rafael Chikvashvili, PhD, guilty of healthcare fraud. Dr. Chikvashvili was the co-owner and CEO of Owings Mills, Md.-based Alpha Diagnostics, which was a portable diagnostic services provider, principally of X-rays.

According to evidence presented at trial, Dr. Chikvashvili was involved in a scheme to defraud Medicare and Medicaid. He and others allegedly conspired to create false radiology, ultrasound and cardiologic interpretation reports. He also allegedly submitted insurance claims for medical examination interpretations that were never completed by licensed physicians, according to the DOJ.

Dr. Chikvashvili allegedly instructed his nonphysician employees to interpret X-rays, ultrasounds and cardiologic examinations, which, according to testimony provided at trial, resulted in two patient deaths.

In one case, an Alpha employee who was not a physician reviewed X-ray images and failed to detect congestive heart failure. As a result, the patient was not transferred to an acute care facility for care and died four days later. In the second case, an Alpha employee misread a patient’s pre-operation X-ray and failed to detect congestive heart failure, which put the patient at an increased risk of bleeding during and after an upcoming elective surgery. Due to the misinterpretation, the patient was cleared for surgery, experienced significant bleeding, and died six days after her chest X-ray was misread.

Dr. Chikvashvili and his co-conspirators allegedly defrauded Medicare and Medicaid of more than $7.5 million through the scheme, which occurred from 1997 through 2013, according to the DOJ.

In addition to healthcare fraud, Dr. Chikvashvili was also found guilty of wire fraud, false statements and aggravated identity theft. He faces a maximum sentence of life in prison for each of the two counts of healthcare fraud resulting in death. He also faces 10 years in prison for each of nine counts of healthcare fraud; 20 years for each of eight counts of wire fraud and for the conspiracy count; a maximum of five years for each of 11 counts of false statements relating to healthcare matters; and a mandatory two years for two counts of aggravated identity theft.

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