Miami, Fla.-based nurse practitioner Elizabeth Hernandez has been convicted of submitting more than $200 million in fraudulent claims to Medicare for unnecessary genetic testing and medical equipment, according to a Sept. 27 report from Medscape.
When Ms. Hernandez is sentenced Dec. 14, she could face up to 75 years in prison. According to prosecutors, she overbilled Medicare for more than $200 million, placing more cancer genetic test orders for Medicare beneficiaries in 2020 than any other clinician in the state.
She pocketed around $1.6 million in the scheme, using the money on cars, home renovations, jewelry and travel, according to the report.
Ms. Hernandez was convicted on 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 was acquitted of two counts of healthcare fraud.
Case prosecutors allege that Ms. Hernandez took advantage of flexible telehealth rules allowed during the COVID-19 pandemic. As part of the scheme, telemarketers would contact Medicare beneficiaries and convince them to request orthotic braces and genetic tests.
Ms. Hernandez would then sign requests, claiming she had examined and treated the patients. Prosecutors alleged that she never saw the patients for whom she ordered a total $14 million in medical equipment. They also allege she ordered $119 million worth of genetic tests for patients she wasn't treating.
She also submitted $1.3 million worth of telemedicine consultations that were not performed, according to the report.