Acting R.I. U.S. Attorney: Nurse Practitioner Charged in Alleged $2.3 Million Health Care Fraud Scheme - Insurance News | InsuranceNewsNet

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August 17, 2021 Newswires
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Acting R.I. U.S. Attorney: Nurse Practitioner Charged in Alleged $2.3 Million Health Care Fraud Scheme

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PROVIDENCE, Rhode Island, Aug. 17 -- The Acting U.S. Attorney for the District of Rhode Island, Richard B. Myrus, issued the following news release on Aug. 16, 2021:

A registered nurse and nurse practitioner who allegedly billed and received more than $2.3 million dollars from commercial health insurers and Medicaid for services he falsely claimed to have performed on patients in Rhode Island, New York, and Florida is in federal custody in Florida and will be brought to Rhode Island to face health care fraud, mail fraud, and money laundering charges, announced Acting United States Attorney Richard B. Myrus.

It is alleged in an indictment returned by a federal grand jury in Rhode Island on August 6, 2021, that among his schemes, Alexander E. Istomin, 55, of Florida, routinely submitted claims for health insurance payments for in-person patient services he claimed to have performed in East Greenwich, New York, and Florida, but that investigators determined were at times when Istomin was actually in another state or out of the country. In other instances, Istomin allegedly billed insurance companies and Medicare for services he claimed to have provided to patients who themselves were out of state or out of the country at the time.

It is alleged in the indictment that as part of the scheme Istomin waived copayments for some Medicare patients despite being aware that waiving copayments is prohibited by Medicare. By waiving copayments they otherwise would be responsible for, Istomin induced his patients not to report his fraudulent billing to Medicare.

According to information presented to the court, no patient services were provided at Istomin's East Greenwich business, Rhode Island Diagnostic Center, or his New York office. Neither office is equipped to provide patient care. It is alleged that Istomin rented and used the East Greenwich office space in name only for billing purposes and to receive insurance payments made payable to his Rhode Island business.

The indictment alleges that since February 2014, in Rhode Island, the Eastern District of New York, the Southern District of Florida, and elsewhere, Istomin fraudulently billed and received approximately $2,309,468.16 from commercial health insurers and Medicare for services he did not provide to patients. The indictment charges Istomin with health care fraud, eight counts of mail fraud, and money laundering.

The government has moved in the indictment that, upon a conviction for health care fraud and mail fraud, Istomin shall forfeit to the United States any and all interest in any property, real or personal, from proceeds traceable to his alleged criminal fraudulent activity, totaling $2,309,468.

A federal criminal complaint is merely an accusation. A defendant is presumed innocent unless and until proven guilty.

Istomin was arrested on August 11, 2021, in Ft. Lauderdale, Florida, by agents from the U.S. Department of Health and Human Services, Office of Inspector General, and the FBI.

The case is being prosecuted by Assistant U.S. Attorney Dulce Donovan, with the Assistance of Assistant U.S. Attorney Mary Rogers.

The matter was investigated the U.S. Department of Health and Human Services, Office of Inspector General, and the FBI.

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