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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Woman Posing as Nurse Sentenced to Prison For Health Care and Wire Fraud, Identity Theft

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison.  In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

How a Fake Nurse Gained Employment for Six Years.

According to a news release from the U.S. Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience. To accomplish the fraud, she obtained the license numbers of real nurses with similar first names. She admitted to providing fraudulent information on job applications to gain employment. She was employed by at least eight different health care providers between September 2012 and November 2018.  She also falsely claimed that she held nursing degrees from two educational institutions, Walters State College and Carson Newman University.

This is a long time, six years, to get away with health fraud.  Usually we only see things like this in Florida.  However, in the past few years, Florida seems to be seeing fewer and fewer fake doctors, nurses and health professionals.  Perhaps the crackdown by the Florida Department of Health on the unlicensed practice of health professions has had some impact on this.


Continuing Lies & Fraudulent Behavior.

While posing as a nurse, the fake R.N. worked in various medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies. She rendered nursing care to numerous patients, dispensed prescription medications, and gained access to patients’ sensitive and private medical information, the U.S. Attorney’s Office said. Furthermore, the woman made false entries in patients’ medical records and submitted or caused the submission of at least $500,000 in false claims to public and private health care benefit programs.

The phony nurse performed procedures that she was, of course, unqualified to perform.  She failed to act or to notify others of necessary procedures for patients and failed to chart and document patient care. According to the written plea agreement, at least one patient required re-admittance to the hospital and an additional three-day hospital stay due to her inept care.

The Tennessee Bureau of Investigation Director David Rausch is quoted in the media as having stated: “Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.”

Judge Clifton L. Corker of the U.S. District Court for the Eastern District of Tennessee sentenced her to 51 months in prison, followed by three years of supervised release. She was also ordered to repay $700,000 in restitution to her employers.

To read the DOJ’s press release about this case in full, click here.

To read about a similar case in Florida, click here to view one of my prior blogs.


Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Morristown woman posed as nurse for 6 years at 8 health care providers.” ABC 6 Local News. (December 12, 2019). Web.

Starks, Ariel. “Fake nurse sentenced to 51 months in prison, ordered to repay employers $700,000.” WVLT 8 Local News. (September 23, 2020). Web.

Bonvissuto, Kimberly. “Nurse imposter who worked in assisted living sentenced for wire fraud, healthcare fraud, identity theft.” McKnight’s Senior Living. (September 25, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

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By George F. Indest III, J.D., M.P.A., LL.M.

By George F. Indest III, J.D., M.P.A., LL.M.

Board Certified by The Florida Bar in Health Law

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