Elizabeth Hernandez, Miami nurse practitioner: the rest of the record
If you searched her name, you probably found a 2023 Justice Department press release and the dozen news stories copied from it. This page sets out what those stories left out, using the trial transcript, the government's own exhibits, and the appeals court's published decision.
Court held what a judge or the appeals court decided
Record the transcript or the government's own exhibits
Family our account and our position
Citations like DE 149:103 mean docket entry 149, page 103, in the trial court's public file.
01Who is Elizabeth Hernandez?
FamilyElizabeth Hernandez is an Advanced Practice Registered Nurse (APRN) from Homestead, in Miami-Dade County, Florida, and the mother of five children. Her youngest is six. From 2018 to 2021 she worked as a contract clinician for telemedicine companies and staffing agencies, reviewing charts and doing patient consults for a set fee per chart. In December 2023 she was sentenced to 20 years in federal prison.
We do not ask anyone to take our word for what happened. We ask that the record be read in full, including the parts that never made it into a press release.
02The "$200 million Medicare fraud" headline, explained
Almost every story about her case says she billed Medicare more than $200 million. Several different numbers are attached to this case, and they measure very different things.
| Figure | What it actually measures | Source |
|---|---|---|
| $200M+ | What genetic testing labs and brace suppliers billed Medicare for orders bearing her signature. The labs and suppliers submitted these claims and were paid for them. She did not. | RecordGX 107, 108 |
| $192M | "Intended loss." The government used this figure, rather than money actually lost, to set her sentencing range. | RecordDE 198 |
| $111M | What Medicare actually paid those labs and suppliers. She was ordered to repay it jointly with others. | Court heldJudgment |
Even the Eleventh Circuit's opinion describes the $111 million as money she "billed." The government's own exhibits show that the labs and suppliers billed it, not her.
03What the Eleventh Circuit admitted on appeal
Court heldOn July 31, 2026, the U.S. Court of Appeals for the Eleventh Circuit published its decision in her appeal. It found two errors at her trial, and then affirmed the conviction anyway on the ground that the errors were "harmless."
Error one: the defense got less time to argue than the prosecution
The trial judge gave the government 40 minutes for closing argument and the defense 30. The only reason offered was that the government carries the burden of proof. The appeals court held that this was an abuse of discretion, because that reason is true in every criminal case.
Error two: the jury was told she had to prove her innocence
RecordGood faith is a complete defense to fraud, and a defendant never has to prove it. The written instructions said so. But when the judge read the instructions aloud to the jury, he said the opposite.
"A defendant is required to prove good faith."
Court heldThe government conceded this was a plain error. The court held it did not affect the outcome.
04Her trial's closing arguments, minute by minute
The appeals court reasoned that nothing important happened in the government's "extra ten minutes." The transcript shows otherwise. Record
- Morning of closings · DE 149:57
The judge announced the 40/30 split that morning. The government's 40 minutes included its rebuttal.
- Government closing · 35.5 min · DE 149:104
The prosecution's first closing alone ran five and a half minutes longer than the defense's entire time.
- Defense closing · 30 min · DE 149:103–104
Defense counsel was cut off mid-sentence. She asked three times for ten more minutes and was refused. When she asked to give closing remarks, the court said "Your time is up."
- Government rebuttal · 4.5 min · DE 149:106
With the defense unable to answer, the government introduced a new theory for the first time: that she deliberately avoided knowing the truth. The judge then instructed the jury on that theory.
- After the jury left · DE 149:129
Defense counsel put on the record the topics she never reached, including the false-statement counts, the amount paid, deliberate ignorance, and good faith.
05The jury acquitted her on two counts
RecordDuring deliberations the jury sent a note saying it could not find paperwork for two patients. It then acquitted her on both counts involving one of them, Counts 6 and 7 DE 149:131, 139–140. That is the verdict of a jury weighing the evidence count by count, not one facing an overwhelming case. The appeals court's opinion does not mention the acquittals.
06Elizabeth Hernandez's 20-year sentence
Court heldJudge K. Michael Moore sentenced her to 240 months, the exact sentence the government asked for. Her sentencing range was driven by the $192 million "intended loss" figure. She was ordered to repay $111,261,526 jointly with others, plus a forfeiture judgment of $1,666,057.24.
RecordAt sentencing the judge twice pointed out that she was the only defendant who went to trial DE 198. Others connected to the same scheme received far less:
| Person | Role, per the courts | Sentence |
|---|---|---|
| Michael Stein | Ran the companies paying kickbacks. His judge found he "identified, recruited and liaised with Hernandez." | 60 months |
| Palatnik | Co-defendant in Stein's case. $61.3M restitution. | 82 months |
| "Mr. Gustavo" Geraldes | Restitution shared with her case. | 28 months, later reduced to time served |
| Elizabeth Hernandez | Nurse practitioner paid per chart. | 240 months |
Those defendants pleaded guilty, some to single counts with five-year maximums, and some cooperated with the government. That explains part of the gap. It does not explain why the person they recruited is serving four to eight times as long.
07Where her case stands today
08Next step: the Supreme Court
FamilyThe Eleventh Circuit denied rehearing on October 21, 2026. Elizabeth's next step is a petition asking the U.S. Supreme Court to hear her case, due in January 2027. The appeals court itself noted that her loss-calculation argument is preserved for Supreme Court review. Alongside that petition, we are asking for clemency.
09One of the #43americans
Elizabeth is Case 9 in 43 Americans, a campaign presenting 43 federal cases in which the court record does not match the government's public account. The group includes nurses, doctors, veterans, engineers, small business owners, public servants and parents. Each case is documented from court filings, transcripts and appellate opinions. The campaign is funded by the families involved and asks for an outside review of these cases and for presidential clemency.
We need a champion for her pardon
A pardon or commutation is the President's decision alone. Petitions to the Pardon Attorney can take years. Cases that move are the ones someone brings directly to the President's attention.
We are looking for a champion to bring Elizabeth's case to President Trump: a member of Congress, a public figure, a faith or community leader, or an advocate with a voice in Washington. If that could be you, or you know who it should be, please reach her sister Evelyn Hernandez on X at @realEvelynH or through Justice and the Record.
How you can help Elizabeth
- Sign the Change.org petition for Elizabeth
- Subscribe to Justice and the Record, where Evelyn Hernandez follows the case and the issues behind it
- Read "Harmless to Whom?" on the appeals court's decision
- Support the #43americans and their call for outside review
- Watch and share the 43 Americans videos on YouTube
- Support or donate to organizations working against government weaponization: Weaponization Watch, Stand in the Gap Foundation and Justice Restoration Foundation
- Write to your members of Congress (a ready-to-send letter is below)
- Share this page. Every link to it helps her real story reach the people searching for her name.
10Write to your representative and senators
Elizabeth's case is not unusual. Congress writes the laws and funds the Justice Department, and it can change three things that shaped her outcome.
Prosecutorial overreach
Require independent review when charges stack counts and "intended loss" figures far beyond what anyone actually received.
The trial penalty
Defendants who exercise their right to a jury trial routinely receive sentences many times longer than those who plead. Elizabeth's 20 years, against 5 and 7 years for two men in the scheme that recruited her, is that penalty in action.
Prosecuting practitioners
Require clinical peer review before a nurse or doctor is criminally charged over medical judgment or Medicare coverage rules, rather than treating billing guidance as criminal law.
Copy the letter below, add your name and town, and send it through your representative's and senators' contact forms.
Frequently asked questions
Who is Elizabeth Hernandez?
Elizabeth Hernandez is an Advanced Practice Registered Nurse from Homestead, Florida, and a mother of five. She worked as a contract clinician for telemedicine companies and staffing agencies from 2018 to 2021, and is now serving a 20-year federal sentence.
What was Elizabeth Hernandez convicted of?
In September 2023 a federal jury in Miami convicted her of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud and three counts of false statements relating to health care matters. The same jury acquitted her on two health care fraud counts.
Did Elizabeth Hernandez bill Medicare $200 million?
No. The $200 million figure is what genetic testing labs and brace suppliers billed Medicare for orders bearing her signature. Medicare paid those companies about $111 million. The labs and suppliers submitted those claims, not her.
What did the appeals court decide in her case?
On July 31, 2026, the Eleventh Circuit held that the trial judge abused his discretion by giving the prosecution more closing-argument time than the defense, and the government conceded a plain error in the oral jury instruction on good faith. The court called both errors harmless and affirmed. Rehearing was denied on October 21, 2026.
How can I help Elizabeth Hernandez?
Sign the Change.org petition, share this page, write to your members of Congress, follow the case on Justice and the Record, and support the 43 Americans campaign at 250pardons.com.
Sources
- United States v. Hernandez, No. 24-10047 (11th Cir. July 31, 2026) (published opinion); rehearing denied Oct. 21, 2026.
- Trial transcripts, United States v. Hernandez, No. 1:22-cr-20152-KMM (S.D. Fla.), DE 143–149; jury instructions, DE 135.
- Sentencing hearing transcript, December 21, 2023, DE 198.
- Government trial exhibits GX 107, 108 and 115.
- United States v. Stein & Palatnik, No. 21-cr-20321-CMA (S.D. Fla.); United States v. Geraldes, No. 22-cr-20141-RNS (S.D. Fla.).