Nurse Practitioner Sentenced for $192 Million Medicare Fraud Scheme That Funded Extravagant Lifestyle
A Florida woman has been sentenced to 20 years in prison for one of the most elaborate fraud schemes in recent history.
According to the Department of Justice, 45-year-old nurse practitioner Elizabeth Hernandez masterminded a fraudulent operation worth over $192 million.
“According to court documents and evidence presented at trial, Elizabeth Hernandez, 45, of Miami, signed thousands of orders for medically unnecessary orthotic braces and genetic testing for Medicare beneficiaries she never spoke to, examined, or treated,” the DOJ wrote in a news release.
“As part of the scheme, telemarketing companies would contact Medicare beneficiaries to convince them to accept orthotic braces and genetic tests and would then send pre-filled orders for these products to Hernandez, who signed them, attesting that she had examined or treated the patients.”
“However, she had never spoken with many of the patients, and she often had others, including non-licensed individuals, sign her name to fraudulent orders,” the release continued.
“Hernandez also falsified information in the orders about beneficiaries’ symptoms and injuries.”
Her scheme also took advantage of the COVID-19 pandemic, where the dramatic rise in government spending and handouts allowed fraudsters to pocket money intended for pandemic relief.
Nurse Practitioner Sentenced for $192M Medicare Fraud Schemehttps://t.co/cCmLxDM5Jh pic.twitter.com/egLaa37zs5
— Criminal Division (@DOJCrimDiv) December 21, 2023
“During the period of the conspiracy, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation,” the release explained.
“In 2020, when Medicare expanded its telemedicine coverage in response to the COVID-19 pandemic, Hernandez also billed Medicare for thousands of telemedicine visits she never performed, routinely billing over 24 hours of telemedicine in a single day.”
Although Hernandez only pocketed a fraction of the $192 million she misappropriated, she still managed to spend her cut on an array of luxury items and services.
“Hernandez personally pocketed approximately $1.6 million in the scheme, which she used to purchase expensive cars, jewelry, home renovations, and travel,” the department revealed.
According to the South Florida Business Journal, Hernandez was found guilty by a jury on Sept. 22 on a plethora of different counts.
These included one count of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud, and three counts of making false statements relating to health care matters.
She is also understood to have acted alone, given that no co-conspirators were charged as part of the investigation.
The prevalence of health care fraud has risen in recent years, with the DOJ noting that they have charged over 5,400 defendants who collectively billed the taxpayer or private insurers a staggering $27 billion since March 2007.
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