A registered nurse and nurse practitioner who defrauded Medicare and commercial payers of almost $12 million has been sentenced to seven years in prison.
Alexander Istomin, 57, ran fraudulent billing schemes in three states seeking payment for patient services that were never performed, according to the Justice Department.
Prosecutors said the in-person services that Mr. Istomin did not perform included supposed patient visits at a "ghost office" in Rhode Island and at offices in Florida and New York. He used seven different tax identification numbers while defrauding eight insurers.
The "ghost office" was an address in East Greenwich, R.I., that Mr. Istomin claimed was part of his medical practice. However, investigators said he used the address only to receive mail, including fraudulently obtained insurance payments.
In many cases, patients Mr. Istomin claimed he met in person were actually out of the country at the time of the supposed visits, according to court documents. In other instances, he was either in a different state or another country, often visiting his native Russia.
As part of the scheme, Mr. Istomin also waived copays for some Medicare patients, despite knowing that waiving copays is prohibited. Investigators said he did so to induce patients not to report his fraudulent billing to Medicare.
He also used patient names and information to get prescriptions filled at various pharmacies and be returned to him, according to prosecutors. Mr. Istomin then distributed those drugs to individuals other than those in whose names the prescriptions were filled.