Nurse Practitioner Sentenced For $12M Medicare Fraud Scheme
Nurse Practitioner (NP) Alexander A. Istomin, 57, was sentenced to 7 years in federal prison on April 5th, 2023. After being accused of defrauding commercial health insurers and Medicare of roughly $12 million in three states, Istomin plead guilty in October 2022. Read the full case here.
According to U.S. Attorney Zachary A. Cunha, Istomin was seeking payments for patient services that were never really performed. Istomin admitted to submitting fraudulent claims for in-person patient services that he did not perform. According to detectives, Istomin had a “ghost office” in Rhode Island and offices located in Florida and New York.
“By billing for services that he never performed, including at a Rhode Island location that was little more than a mail drop, Alexander Istomin thought he could make off with millions in taxpayer and insurance dollars that were meant to fund real medical care, for real people, all without consequence,” remarked U.S. Attorney Zachary Cunha. “He was very much mistaken. The sentence imposed reflects both this Office’s commitment to bring to justice individuals who perpetrate this kind of brazen fraud and abuse of our health care system, and should serve notice of the consequences for those who seek to enrich themselves through schemes like these.”
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The charges against Alexander istomin
He plead guilty to 11 counts of health care fraud, mail fraud, aggravated identity theft, and causing the introduction of misbranded drugs into interstate commerce.
Officials believed that he would claim to meet the patient in person but at the time the patient was actually out of the country. Istomin claimed that he was seeing patients in other countries, more specifically Russia. He was able to go on with the fraud for so long because he also had seven different tax identification numbers.
"With the proceeds of his illegally gotten gains, he bought a million-dollar home in Florida and expensive cars," Assistant U.S. Attorney Dulce Donovan wrote in a sentencing memorandum.
"In truth, the defendant never conducted a medical practice out of that office and every service he claimed to have provided in Rhode Island was a lie," Donovan included. "The office was empty, no patients were ever seen there, and the only time the defendant was in Rhode Island was to pick up his mail."
Beyond billing, for “fake” visits he would also use those patient names to fill prescriptions and then sell them to other people. To avoid detection, Istomin would wave copayments for some of his patients to prevent them from reporting him. Copayments on Medicare can range from $0 to as much as $200 depending on services rendered and subspecialty.
“Alexander Istomin went to great lengths to conceal his multi-state, multi-million-dollar health care fraud scheme, billing for services he never provided and patients he never saw. With the proceeds of his illegally gotten gains, he bought a million-dollar home in Florida and expensive cars. This sentence is more than just, given that this is not the first time Mr. Istomin has been accused of health care fraud, nor is it his first brush with the law,” said Joseph R. Bonavolonta, Special Agent in Charge of the FBI Boston Division. “The unscrupulous tactics he used to steal from taxpayers is what drives our investigators to combat healthcare fraud. After all, these taxpayer-funded programs are designed to provide essential medical services to the elderly and disadvantaged, not to enrich corrupt health care professionals and other fraudsters.”
Isomin's Sentencing
U.S. District Court Chief Judge John J. McConnell, Jr., sentenced him to 84 months and also three years of federal, supervised release as well as paying a fine of $30,000 and restitutions to Medicare and private insurers totaling $11,923,686.30.
The investigation into Istomin was a collaboration between the U.S. Department of Health and Human Services, Office of Inspector General, Federal Bureau of Investigation, and the Food and Drug Administration, Office of Criminal Investigations.
