Florida nurse convicted for fraudulent orders billing Medicare for $200M

A Florida nurse practitioner was convicted this week by a federal jury for her participation in a $200 million healthcare fraud scheme.

Elizabeth Hernandez, 45, “signed thousands of orders” for orthotic braces and genetic tests that were medically unnecessary and billed to Medicare, the Department of Justice (DOJ) said in a release announcing the conviction.

Hernandez was sent pre-filled orders for these products from telemarketing companies, which had already convinced Medicare beneficiaries to put in requests for the tests and equipment, law enforcement said. Hernandez signed off on the orders despite never having met or spoken with the patients, they said.

“In 2020, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation, including oncologists and geneticists,” the DOJ said. “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 one count 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 a maximum of 20 years in prison for the conspiracy count, 10 years for each count of healthcare fraud and five years for each count of making false statements.

Hernandez is scheduled to be sentenced Dec. 14.

Other collaborators have already pleaded guilty and have been sentenced to prison for their roles in the broad telemedicine scheme, per news reports. These include Michael Stein, 36, and Leonel Palatnik, 44, who co-owned Texas-based genetic testing labs that fraudulently billed for the ordered tests and coordinated the telemedicine approvals.

Earlier this year, DOJ brought criminal charges against 11 defendants in connection to a $1.9 billion telemedicine scheme that was “one of the largest healthcare fraud schemes ever prosecuted.”

Since March 2007, the DOJ’s Health Care Fraud Strike Force program has charged more than 5,000 defendants who collectively billed federal and private health insurers for more than $24 billion, the department said in June.