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Florida Woman Sentenced to 20 Years for Medicare Fraud Scheme
A Florida woman has been sentenced to 20 years in prison for her role in a massive Medicare fraud scheme that netted her over $1.6 million in ill-gotten gains. Elizabeth Hernandez, 45, of Miami, was caught up in a scheme to defraud Medicare by submitting over $192 million in claims for genetic tests and durable medical equipment that patients did not need and telemedicine visits that never occurred.
According to court documents and evidence presented at trial, Hernandez signed thousands of orders for medically unnecessary orthotic braces and genetic testing for Medicare beneficiaries she never spoke to, examined, or treated. 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, Hernandez had never spoken with many of the patients, and she often had others, including non-licensed individuals, sign her name to fraudulent orders. She also falsified information in the orders about beneficiaries’ symptoms and injuries.
During the period of the conspiracy, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation. 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.
Hernandez personally pocketed approximately $1.6 million in the scheme, which she used to purchase expensive cars, jewelry, home renovations, and travel.
The case was investigated by the Health and Human Services Office of Inspector General and the FBI Miami Field Office, and was prosecuted by the Criminal Division’s Fraud Section. Since March 2007, the Health Care Fraud Strike Force Program has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion.
Hernandez, a nurse practitioner, was sentenced to 20 years in prison for her role in the scheme. She will also be required to pay restitution to Medicare.
In related news, the Centers for Medicare & Medicaid Services are taking steps to hold providers accountable for their involvement in health care fraud schemes.
Key Facts
- State: Florida
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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