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A federal jury in Miami convicted a Florida nurse practitioner of health-care conspiracy and other charges for enjoying a key role in a scheme that swindled lots of of tens of millions of dollars from Medicare.
Elizabeth Hernandez, 45, fraudulently billed Medicare for greater than $200 million in orthotic braces and genetic tests that were medically unnecessary, based on the Department of Justice.
Medicare is the federal program that gives health coverage to primarily older Americans.
Hernandez, who was found guilty Thursday by jurors after a trial that lasted several days, participated in a broad scheme in which telemarketing corporations would contact Medicare patients to influence them to request unnecessary braces and tests, the DOJ said.
These corporations then sent pre-filled orders to Hernandez, who signed them, attesting that she had examined or treated the patients although she had never spoken with lots of them, prosecutors said.
Hernandez routinely billed Medicare for greater than 24 hours of purported “office visits” in a single day, the DOJ said.
And, “In 2020, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than another provider in the nation, including oncologists and geneticists,” the department said.
She personally pocketed $1.6 million in stolen money which she used to purchase pricey cars, jewelry, home renovations and trips, the prosecutors said.
Considered one of Hernandez’s co-conspirators, Michael Stein, pleaded guilty in April to 1 count of defrauding the USA by paying and receiving kickbacks. Stein was sentenced to 5 years in prison in June.
Stein ran two corporations, 1523 Holdings and Growthlogix, that paid health-care providers bribes and kickbacks to order genetic tests that were medically unnecessary.
Hernandez is scheduled to be sentenced Dec. 14. She faces a maximum possible sentence of 20 years in prison on the highest count of conspiracy to commit health care fraud, with lesser maximums for health care fraud and making false statements.
A lawyer for Hernandez didn’t immediately reply to a request for comment.