A federal jury in Miami has found Elizabeth Hernandez, a 45-year-old nurse practitioner from Florida, guilty of charges related to her involvement in a massive Medicare fraud scheme. The verdict was delivered on September 20, 2023, and the fraudulent claims exceeded $200 million, the Justice Department announced on Thursday.
According to the DOJ, Hernandez orchestrated a scheme that exploited Medicare through fraudulent billing for medically unnecessary orthotic braces and expensive genetic tests, which led to $200 million in fraudulent Medicare billings. According to court documents and trial evidence, Hernandez used telemarketing companies to persuade Medicare beneficiaries to request unnecessary medical equipment and unwarranted genetic tests. Once the Medicare beneficiaries agreed to the requests, the telemarketers would send pre-filled orders to Hernandez who had never actually spoken to any of the patients. Hernandez would then sign the orders, stating that she had treated or examined those patients, though she hadn’t.
Shockingly, Hernandez ordered the most cancer genetic tests for Medicare beneficiaries than all other providers, including oncologists and geneticists, in 2020.
Hernandez billed Medicare as if she had conducted extensive office visits with these patients, often billing more than 24 hours of “office visits” in a single day. Hernandez personally profited from the scheme, amassing approximately $1.6 million, which she used to fund extravagant purchases, including luxury cars, jewelry, home renovations, and travel.
Hernandez faces one count of conspiracy to commit health care fraud and wire fraud, four counts of healthcare fraud, and three counts of making false statements relating to health care matters. Her sentencing is scheduled for December 14, where she could face up to 20 years in prison for conspiracy, 10 years in prison on each health care fraud count, and five years in prison on each false statement count.
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