Sat. Sep 21st, 2024

The Social Secuity Administration estimates that Medicare fraud costs taxpayers an estimated $60 billion per year. (Photo by Getty Images)

The Iowa Board of Nursing has revoked the license of an advanced registered nurse practitioner accused of funding a lavish lifestyle with her share of the proceeds from a nationwide criminal conspiracy that cost Medicare and other insurers $192 million.

State records show that in early 2019, the Iowa Board of Nursing issued Elizabeth Hernandez a license to practice in Iowa. In April 2022, the board learned that Hernandez, then living in Florida, had been indicted on multiple charges related to an alleged scheme involving several companies that used her to prescribe unnecessary tests and medical equipment for “patients” she had never seen.

Hernandez personally collected at least $695,000 from fraudulent billings submitted to the taxpayer-funded Medicare program, prosecutors alleged. In September 2023, Hernandez was convicted of seven federal offenses involving wire fraud and health care fraud and earlier this year she was sentenced to 20 years in prison.

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At her sentencing, federal prosecutor Andrea Savdie told the court that out of all the telemedicine practitioners involved in the wide-ranging scheme, Hernandez was “by far, the most egregious and prolific” and had prescribed fraudulent genetic tests for individuals throughout the country.

“She took her fraud national, prescribed these for beneficiaries in every single state,” Savdie said, noting that Hernandez prescribed tests and medical equipment such as leg braces for tens of thousands of Medicare and insurance beneficiaries with whom she had never spoken. To do this, Savdie said, Hernandez often claimed to have provided more than 24 hours of telemedicine services in a single day.

What she did, did not even resemble medicine. She was not speaking to any of these beneficiaries. She was laughing with (a colleague) in text messages about the beneficiaries, faking their injuries…

– Federal prosecutor Andrea Savdie

Even after law enforcement alerted Hernandez to the illegal nature of her actions, Savdie told the court, Hernandez “doubled down” and ramped up her billings. Savdie acknowledged that Hernandez had collected only a fraction of the $192 million in fraudulent billings tied to the scheme, but had still collected $1.6 million over three years.

“What she did,” Savdie told the court, “did not even resemble medicine. She was not speaking to any of these beneficiaries. She was laughing with (a colleague) in text messages about the beneficiaries, faking their injuries … She did this day after day. It was not a one-time occurrence. It was every single day for years.”

Savdie also told the court Hernandez wasn’t merely trying to provide for her family. “This was all motivated by greed,” she said. “Ms. Hernandez had five cars. She spent $66,000 during this period, during the conspiracy period, on jewelry … She was going to spas and getting facials, and, somehow, she was paying for it with telemedicine. She took her entire family to Lake Tahoe right before her trial in this case.”

After her sentencing, Hernandez’s attorney filed an emergency motion with the court asking that a bond be set so that she could be released from prison while her appeal was pending. He told the court Hernandez had six allergic reactions to the underwear she had been issued in prison and described the allergies as life threatening.

The judge in the case denied the motion, and Hernandez’s conviction remains under appeal while she is incarcerated. In June, the Iowa Board of Nursing revoked Hernandez’s license to practice in Iowa.

Separate fraud case settled

Earlier this year, the U.S. Attorney for the Northern District of Iowa agreed to settle a fraud case involving another Iowa-licensed registered nurse practitioner, Ashley Brown of Des Moines.

Brown agreed to pay $52,560 to the United States to resolve civil allegations that she violated federal law by signing hundreds of medically unnecessary prescriptions for expensive orthotic braces in exchange for kickbacks.

The federal government had alleged that from April 17, 2020, to May 19, 2021, Brown knowingly submitted more than $1 million in false claims for payment to Medicare while working for a company called Barton Associates.

Barton Associates is also named in the Hernandez case. The company allegedly paid Hernandez $200,643 after recruiting her to sign telemedicine orders for a man named Richard Epstein. Hernandez allegedly signed prescription orders that Epstein sold so they could be turned into billable claims submitted to Medicare. Barton Associates, prosecutors alleged, paid Hernandez for her work on behalf of Epstein’s companies.

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