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Medicare enrollment form and glasses
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Alexander Istomin, a registered nurse and nurse practitioner, really didn’t want to get close to the patients. So, he made his own business. A business built to defraud Medicare of nearly $12 million for patient services that never happened. Using the address of an empty office located in Rhode Island, Istomin routinely submitted fraudulent claims for in-person patient services that he never performed. The office was empty, no patients were ever seen there, and the only time Istomin was in Rhode Island was to pick up his mail. Istomin used seven different tax identification numbers while defrauding the U.S. taxpayer out of a total of $11,923,686.30.

Istomin’s claims were filled with lies. Many patients that supposedly were receiving treatment in Istomin’s office were actually out of the country during the time of supposed treatments. Or the patients were in the country, but Istomin was outside of the country. He was in Russia more than Rhode Island! He was able to go on with the fraud for so long because he had seven different tax identification numbers to conduct fraud with.

Beyond billing, for “fake” visits he would also use those patient names to fill prescriptions and then sell them to other people. To prevent patients from reporting him, Istomin would wave copayments as a bonus to receiving drugs. Someone eventually reported him and now Istomin is serving seven years in prison.

Great job by the U.S. Department of Health and Human Services in this investigation.

Today’s Fraud Of The Day is based on article “Nurse Practitioner Sentenced For $12M Medicare Fraud Scheme” published by Nurse.org on April 10, 2023

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.

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