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Breaking Records

Healthcare-8
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Either Elizabeth Hernandez can’t keep track of time, or she believed that the government didn’t check its bills. Maybe both! Either way, when Hernandez filed her fraudulent invoices to Medicare, she broke a few records. Records that should have been a red flag to the Department of Health and Human Services!  For instance, maybe there should have been a pause in payments  when Hernandez ordered more cancer genetic tests for Medicare beneficiaries in 2020 than any other healthcare provider in the country, including oncologists and geneticists. Or maybe, someone should have double checked the invoices when Hernandez billed more than 24 hours of alleged “office visits” in a day! A record for sure! Something to brag about while she is in prison.

For all her record breaking, Hernandez’s responsibility in this scheme was little more than a signature. Telemarketing companies reached out to Medicare patients, persuading them to request unnecessary braces and tests. The telemarketing companies would then send pre-filled orders to Hernandez. She in turn would then sign these orders, falsely affirming that she had examined or treated the patients, even though she had never spoken with many of them. Hernandez was responsible for fraudulently billing Medicare for over $200 million in orthotic braces and genetic tests that were medically unnecessary.

As a result of her participation in the scheme, Hernandez personally pocketed $1.6 million, which she used to finance purchases of luxury cars, jewelry, home renovations, and trips, according to prosecutors. Hernandez is scheduled to be sentenced on December 14. The maximum possible sentence for the top count of conspiracy to commit healthcare fraud is 20 years in prison.

Today’s Fraud of The Day is based on article “Landmark case: Florida Nurse Practitioner Found Guilty in Massive $200 Million Medicare Fraud Scandal” published by VIGOUR TIMES on September 24, 2023 

A federal jury in Miami has convicted a Florida nurse practitioner of health-care conspiracy and other charges for her involvement in a scheme that defrauded Medicare of hundreds of millions of dollars.

Elizabeth Hernandez, 45, has been found guilty by jurors after a trial that lasted several days. She was responsible for fraudulently billing Medicare for over $200 million in orthotic braces and genetic tests that were medically unnecessary, according to the Department of Justice.

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