Nurse Practitioner Admits to Perpetrating $4.37 Million Health Care Fraud Scheme; Will Forfeit the Profits of His Fraud
PROVIDENCE, R.I. – A registered nurse and nurse practitioner who fraudulently billed commercial health insurers and Medicare nearly $4.4 million for services that he falsely claimed to have provided to patients in Rhode Island, New York, and Florida, pleaded guilty on Wednesday in federal court in Rhode Island to an eleven-count information charging him with health care fraud, mail fraud, aggravated identity theft, and causing the introduction of misbranded drugs into interstate commerce, announced United States Attorney Zachary A. Cunha.
Alexander A. Istomin, 56, admitted that he routinely submitted fraudulent claims for in-person patient services that he falsely claimed to have performed at his offices in Rhode Island, New York, and Florida. In some instances, the patients that Istomin claimed he met with in person were out of the country at the time of the alleged visits. On many other occasions that he claimed to have been seeing patients, Istomin himself was either in a different state or another country, often times in Russia. The investigation also determined that the supposed office that Istomin maintained in East Greenwich, and to which he had some payments mailed, was a non-existent medical practice at which no medical services were provided.
Additionally, Istomin admitted to a federal judge that he waived copayments for some Medicare patients, despite being aware that waiving copayments is prohibited. By waiving copayments that patients otherwise would be responsible for, Istomin induced his patients not to report his fraudulent billing to Medicare.
Istomin also admitted that he carried out schemes in which he would use patient names and information to get prescriptions to be filled at pharmacies. He arranged for those prescriptions to be returned to him so that he could then distribute those drugs to individuals other than those in whose names the prescriptions were filled.
According to a signed Plea Agreement filed with the court, in addition to pleading guilty to charges of health care fraud, mail fraud, aggravated identity theft, and causing the introduction of misbranded drugs into interstate commerce, Istomin will forfeit $4,379,158.98, the sum of money equal to the amount he received from perpetrating health care fraud.
Istomin is scheduled to be sentenced on January 26, 2023. The defendant’s sentences will be determined by a federal district judge after consideration of the U.S. Sentencing Guidelines and other statutory factors.
The case is being prosecuted by Assistant U.S. Attorney Dulce Donovan, with the assistance of Assistant U.S. Attorneys Milind M. Shah and Mary Rogers.
The matter was investigated the U.S. Department of Health and Human Services, Office of Inspector General; Food and Drug Administration, Office of Criminal Investigations; and the FBI.