Nurse practitioner convicted of role in $12M fraud scheme – Becker’s Hospital Review | Healthcare News
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A federal jury convicted a nurse practitioner for her role in a $12.1 scheme to defraud Medicare by ordering medically unnecessary cancer genetic tests for hundreds of patients she never met or examined.
What happened?
- From 2018 to 2019, Scharmaine Lawson Baker, 58, worked as an independent contractor for a company that claimed to provide telehealth services, according to a July 24 Justice Department news release.
- In that role, she signed hundreds of orders for medically unnecessary cancer genetic testing after phone calls that typically lasted less than 60 seconds.
- She falsely diagnosed patients to justify the tests.
- She never reviewed any of the test results, including when the results showed that patients actually had variants predisposing them to certain cancers.
- In total, she caused more than $12.1 million in fraudulent claims to Medicare and the labs involved in the scheme received more than $1.5 million in reimbursements for unnecessary testing. In exchange for signing orders, Ms. Baker accepted kickbacks and bribes from the telehealth company.
- She was convicted of six counts of healthcare fraud and is scheduled to be sentenced on Nov. 19. She faces up to 60 years in prison.