Florida nurse convicted in $200M Medicare fraud scheme, could spend decades in prison

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.”

The federal jury convicted Hernandez of conspiracy to commit healthcare fraud and wire fraud, four counts of healthcare fraud and three counts of making false statements related to healthcare matters. She faces up to 20 years in prison for conspiracy, 10 for each fraud count, and five for each false statement count, according to the DOJ. She is scheduled to be sentenced Dec. 14. 

Some of Hernandez’s co-conspirators have already pled guilty and been sentenced to prison, according to coverage in the Miami Herald. For example, Leonel Palatnik, the co-owner of Panda Conservation Group, pleaded guilty and was sentenced to nearly seven years in prison for his role in multiple fraud schemesPanda Conservation Group billed many unnecessary genetic tests billed signed by Hernandez to Medicare.

Chad Van Alstin Health Imaging Health Exec

Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.