An unqualified executive at an Owings Mills medical firm allegedly reviewed X-rays and other tests, potentially endangering patients, according to court documents filed by federal authorities.
The allegations were laid out in the documents by the FBI, which has accused Alpha Diagnostics officials of defrauding Medicare by at least $3.3 million. The FBI raided the firm's offices in Owings Mills and Harrisburg, Pa., in October but declined to characterize the investigation at the time.
According to the FBI, the executive reviewed the diagnostic tests and lied by saying they were being reviewed by a team of doctors at a separate firm. That led to medical conditions of some residents at a Virginia nursing home being overlooked, an FBI agent wrote in the court filings.
The FBI agent said the company also routinely overbilled Medicare by claiming technicians carried out additional X-rays.
Jeff Ifrah, an attorney for Alpha Diagnostics, said the company disputes the allegations and has been carrying out an internal investigation in addition to cooperating with federal authorities.
"Health care is an intensely regulated industry," Ifrah said. "It is not unusual for even brand-name organizations to be subject to government inquiries like this one.
"It would be absolutely against all the policies Alpha has in place" if an unqualified person was interpreting the exams, he added.
No charges have been filed in the case. FBI agents working with the U.S. Department of Health and Human Services seized $1 million from the company's bank accounts at the time of the office raids, court records show.
The forfeiture filings name Rafael Chikvashvili, the company's chief executive officer, and Timothy Emeigh, a vice president who is accused of performing the improper reviews, as targets of the investigation.
Ifrah said that Chikvashvili "is very focused on defending his reputation" and that Emeigh resigned shortly after the federal investigation began.
Emeigh could not be reached for comment, and Elizabeth Oyer, a federal defender representing him, declined to comment on the allegations.
Alpha Diagnostics provides X-ray services and other diagnostic tests at the order of doctors. Typically, the test results are reviewed by another doctor, who describes the findings in a formal report that can then be used to help diagnose an illness, according to a summary of the process described in the legal papers.
Details of the process must be accurately noted in a claim filed with Medicare.
Emeigh is a licensed radiographer — also known as an X-ray technologist — but is not licensed as a doctor in Maryland or Pennsylvania and not qualified to interpret X-rays, according to the FBI.
He said in reports written to help physicians make diagnoses that the company's exams were being sent for review by a separate firm called Alpha Rads and evaluated by a crew of doctors, according to the court filings.
"In actuality, Emeigh is 'Alpha Rads' and is the person reading, interpreting and writing the reports for studies," the FBI agent wrote.
Authorities asked one doctor to review 116 reports filed in his name, and he said 97 of them were "definitely false reports," according to the filings. The doctor told authorities that he had reviewed tests for Alpha Diagnostics until he closed his office in February 2012, but only five of the reports looked like ones he had produced.
The physician, who is not named in the filing, told agents that having reports not reviewed by a qualified doctor could lead to bone problems from overlooked fractures, organ failure from missed kidney stones, cancer going undetected and gall bladder problems.
The Virginia nursing home, which is not named, stopped using Alpha Diagnostics after a radiology report by a hospital contradicted one of its reports, and other facilities called the company to complain about similar problems, according to an administrator at the nursing home and an unnamed former company employee interviewed by investigators.
Emeigh, who has been licensed as a radiographer since 1993, was fined $1,200 by the Maryland Board of Physician Quality Assurance in 2002 for promoting an unqualified man to the position of X-ray technician at Alpha Diagnostics.