A federal jury has convicted a Florida nurse practitioner for her role in a conspiracy to defraud Medicare by submitting fraudulent claims for unnecessary tests and services in excess of $200 million. She was convicted of multiple felonies and could serve a lengthy prison sentence.
According to a release from the Department of Justice (DOJ), Elizabeth Hernandez signed thousands of orders for unnecessary genetic tests and orthotic braces for patients she had not even examined. The larger scam operated via telemarketing companies, which would “contact Medicare beneficiaries to convince them to request orthotic braces and genetic tests.” The beneficiaries would be told send in pre-filled orders for these products, according to the DOJ, and Hernandez would sign those orders despite not speaking to many of the patients.
“In 2020, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation, including oncologists and geneticists,” according to the statement from the DOJ. “She then billed Medicare as though she were conducting complex office visits with these patients, and routinely billed more than 24 hours of ‘office visits’ in a single day. Hernandez personally pocketed approximately $1.6 million in the scheme, which she used to purchase expensive cars, jewelry, home renovations, and travel.”
Source: Florida nurse convicted in $200M Medicare fraud scheme, could spend decades in prison / Health Exec