Florida nurse practitioner convicted in $200 million Medicare fraud scheme

A federal jury in Miami convicted a Florida nurse practitioner of health-care conspiracy and other charges for playing a key role in a scheme that swindled hundreds of millions of dollars from Medicare.

Elizabeth Hernandez, 45, fraudulently billed Medicare for more than $200 million in orthotic braces and genetic tests that were medically unnecessary, according to the Department of Justice.

Medicare is the federal program that provides health coverage to primarily older Americans.

Hernandez, who was found guilty Thursday by jurors after a trial that lasted several days, participated in a broad scheme in which telemarketing companies would contact Medicare patients to persuade them to request unnecessary braces and tests, the DOJ said.

These companies then sent pre-filled orders to Hernandez, who signed them, attesting that she had examined or treated the patients although she had never spoken with many of them, prosecutors said.

Hernandez routinely billed Medicare for more than 24 hours of purported “office visits” in a single day, the DOJ said.

And, “In 2020, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation, including oncologists and geneticists,” the department said.

She personally pocketed $1.6 million in stolen money which she used to buy pricey cars, jewelry, home renovations and trips, the prosecutors said.

One of Hernandez’s co-conspirators, Michael Stein, pleaded guilty in April to one count of defrauding the United States by paying and receiving kickbacks. Stein was sentenced to five years in prison in June.

Stein ran two companies, 1523 Holdings and Growthlogix, that paid health-care providers bribes and kickbacks to order genetic tests that were medically unnecessary.

Hernandez is scheduled to be sentenced Dec. 14. She faces a maximum possible sentence of 20 years in prison on the top count of conspiracy to commit health care fraud, with lesser maximums for health care fraud and making false statements.

A lawyer for Hernandez did not immediately respond to a request for comment.