When we pay, or our insurance pays, for services rendered by a doctor or medical facility, we expect that we are being cared for by professionals. No one would want someone without experience in reading x-rays to diagnose whether or not they had a broken bone. When such things do happen, however, the perpetrators can face serious charges.
The owner of an imaging company that provided services to nursing homes on the east coast is facing possible life in prison over the deaths of two patients.
Rafael Chikvashvili is the owner of Alpha Diagnostics, LLC. He was convicted earlier this month of two counts health care fraud resulting in death, wire fraud, false statements, and aggravated identity theft. The two charges of health care fraud resulting in death carry a possible life sentence each. The other charges carry a possible 20 years in prison.
Chikvashvili allegedly instructed non-physician employees to interpret x-rays, ultra sounds, and cardiologic reports and then draft false reports. Chikvashvili would then forge a physician signature on the reports and submit them to Medicare.
As a result of having their x-rays interpreted by unqualified individuals, two patients lost their lives.
Alpha employees did not notice that a nursing home patient’s x-ray indicated that she had congestive heart failure. Instead of transporting her to another facility, which might have prolonged her life, the woman stayed at the nursing home. She died four days later.
In another instance, a woman’s x-ray was again misinterpreted. Alpha employees failed to diagnose that she had mild congestive heart failure. This condition can raise the risk of bleeding during surgery. The elderly patient then underwent elective surgery. She began bleeding during and after the surgery as the result of the heart failure. She died six days later.
Alpha Diagnostics defrauded Medicare of $7.5 million between 1997 and 2013, authorities allege. The company had submitted claims to Medicare on both patients, assuring their images had been interpreted by qualified professionals.
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