UNITED STATES OF AMERICA v. RAFAEL CHIKVASHVILI
US Court of Appeals for the Fourth Circuit, Wilkinson, June 9, 2017,
Health Care Fraud– Health Care Fraud can apply to the execution of a fraudulent scheme when execution of the scheme results in death.

Facts: Chikvashvili ran a company providing on-site diagnostic imaging services. His company billed patients and their insurers for both the administration of an image such as an x-ray as well as its interpretation by a “qualified doctor.”
Chikvashvili had his employees bill for multiple trips to the same facility even if they were already there and had his employees change diagnosis codes so that they would be qualify for Medicare reimbursement.
Moreover, instead of using actual doctors Chikvashvili had his employees give their opinion and sign as if they were actually doctors (they were not) or use a copy of a real doctor’s signature.
Evidence was presented at trial that two patients died because their x-rays were interpreted incorrectly.
Chikvashvili was convicted after a jury trial of various charged related to health care fraud and other fraud charges.
On appeal, Chikvashvili argued that he shouldn’t be convicted because Health Care Fraud only applies to his billing practices, not the fact that he caused the death of patients.

Held: The Fourth Circuit disagreed. Chikvashvili’s scheme of making money by having technicians diagnose x-rays instead of doctors resulted in the deaths of two patients. Therefore, he is liable under the act for more than just his billing practices.