Nurse practitioner convicted in $200M fraud scheme

A Florida nurse practitioner was convicted Sept. 20 in a $200 million Medicare fraud scheme.

Elizabeth Hernandez, 45, was found guilty of signing thousands of orders for medically unnecessary orthotic braces and cancer genetic tests. As part of the scheme, telemarketing companies contacted Medicare beneficiaries to convince them to request the braces or genetic tests, then sent pre-filled orders to Ms. Hernandez, who signed them often without speaking to the patient, according to a Justice Department press release. 

In 2020, Ms. Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation, including oncologists and geneticists. She also billed Medicare for conducting complex office visits with the patients and routinely billed more than 24 hours of "office visits" in a single day. It's estimated she pocketed more than $1.6 million from the scheme.

The jury convicted Ms. Hernandez of one count of conspiracy to commit healthcare fraud and wire fraud, four counts of healthcare fraud, and three counts of making false statements relating to healthcare matters. She is scheduled to be sentenced Dec. 14. 

A co-conspirator in the scheme, Michael Stein, pleaded guilty in April to one count of defrauding the United States by paying and receiving kickbacks. He was sentenced to five years in prison in June, CNBC reported Sept. 21.

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