On April 10, the Attorney General’s Office announced that a 38-year-old Georgia woman had been sentenced for stealing another person’s identity to illegally practice as a nurse in Vermont.
In 2022, the defendant impersonated a licensed nurse from Florida to obtain pandemic-related emergency authorization and fraudulently register as a nurse in both Vermont and New Hampshire. She then worked in residential care facilities in Vermont and other states, at a level of care that she had not been trained in or certified to safely perform.
Investigators with the Vermont Secretary of State’s Office of Professional Regulation (OPR) discovered the defendant’s true identity in April 2023, and referred the case to the Attorney General’s Medicaid Fraud and Residential Abuse Unit (MFRAU) for joint investigation. Upon learning that the defendant had already left Vermont, investigators obtained a search warrant for her cell phone, enabling them to locate and apprehend her in Cobb County, Georgia.
The defendant pleaded guilty to felony identity theft and misdemeanor unauthorized practice of nursing. She was sentenced to three years in prison, suspended for six years of probation. Supervision of her sentence will be transferred to Georgia, where she also faces concurrent prosecution for other criminal charges. She will also be barred from working in any future capacity as a Medicaid service provider.
Compliance Perspective
Issue
It is a crime to impersonate a licensed healthcare professional, use someone else’s license or registration, or practice nursing without proper authorization. Healthcare facilities, particularly those receiving government funds, are required to conduct thorough background checks on all prospective employees prior to hiring. These checks must include a criminal background check, a sex offender registry search, identity verification, and confirmation of employment and education history. For positions requiring licensure or certification, verification of those credentials must be conducted and documented in the individual’s personnel file. Employers are also required to check the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) to ensure that candidates are not barred from participating in federally funded healthcare programs. Once hired, employees must continue to be monitored to ensure that they maintain the legal qualifications to work in a healthcare setting. This includes regular checks of licensing status, ongoing review of exclusion databases, and prompt identification of any disciplinary actions that may affect their eligibility. Routine monitoring will ensure that employees are legally permitted to practice healthcare in your facility.
Discussion Points
- Review policies and procedures for verifying the status of professional licenses and monitoring the OIG’s LEIE. Update as necessary.
- Train appropriate staff to follow protocols for verification of licenses and certifications of employees at the time of hire and on an ongoing basis to ensure that those licenses remain up to date and are unencumbered. Ensure that training is provided to licensed personnel about their responsibility to maintain an active license and to notify administration should their license be suspended, expire, or if they are added to the OIG’s LEIE.
- Periodically audit to verify that the licensing and certifications of employees are valid and up to date and that OIG LEIE checks are routinely conducted. In addition to background and credentialing checks, staff should remain alert for signs of identity fraud such as forged or altered identification, mismatched personal details, or duplicate Social Security numbers, and immediately address any suspicious findings.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*
