Miami nurse practitioner sentenced in $192M Medicare fraud

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A Miami nurse practitioner was sentenced on Friday to 20 years in prison for her role in a scheme to defraud Medicare by submitting more than $192 million in claims for unnecessary genetic tests and orthotics, as well as telemedicine visits that did not occur, the U.S. Department of Justice (DOJ) said in a statement.

Elizabeth Hernandez was convicted in September of healthcare fraud, false statements, and conspiracy to commit healthcare fraud and wire fraud. Prosecutors said that as part of a scheme in which telemarketers would coax Medicare beneficiaries to accept medically unnecessary genetic tests and orthotic braces, Hernandez signed thousands of pre-filled orders for these beneficiaries whom she had never spoken to, examined, or treated. In addition, she often had others sign fraudulent orders in her name.

Hernandez personally netted approximately $1.6 million from the scheme; according to a statement from the DOJ, Hernandez ordered more genetic tests for Medicare beneficiaries while the scheme was ongoing than any other provider in the nation. When Medicare expanded its telemedicine coverage in 2020 in response to the COVID-19 pandemic, Hernandez billed Medicare for thousands of telemedicine visits that never happened. She often billed for more than 24 hours of telemedicine visits during a single day.

Health and Human Services Office of Inspector General (HHS-OIG) and the FBI Miami Field Office investigated the case.

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