Justice sign on a Law Courts building

By Shereen Siewert

A federal grand jury on Wednesday indicted two California women accused of a massive health care fraud scheme at nursing homes in Rhinelander, Wisconsin Rapids and other Wisconsin cities.

Lauryn Nelson, 40, San Pedro, California, and Marie De La Torre, 50, Corona, California, are charged with conspiring to commit health care fraud, while De La Torre is also charged with eight additional counts of health care fraud, through a scheme to defraud the Medicare Program administered by the U.S. Department of Health and Human Services. 

The indictment alleges that the conspiracy operated from February to September 2015.

Prosecutors say Nelson and De La Torre, both licensed vocational nurses, worked for a company not named in the indictment that performed genetic testing of residents in nursing homes to determine how different residents metabolized medication, which might result in changes in medication prescribed to the residents. 

Nelson and De La Torre allegedly went into four nursing homes in Wisconsin, located in Milwaukee, Rhinelander, Oshkosh, and Wisconsin Rapids, to do the genetic testing and obtained medical information about residents which they used to create fraudulent wound care supply orders they submitted to Medicare for reimbursement.  

Neither Nelson nor De La Torre had any involvement in caring for wounds of the Wisconsin nursing home residents, prosecutors say.

The wound care supplies were then shipped to the California office of the company for which they worked, instead of to the Wisconsin nursing homes, billing Medicare $552,889, prosecutors say.

Medicare paid $431,579 for the supplies, according to court filings.

If convicted, Nelson and De La Torre face a maximum penalty of 10 years in federal prison on Count 1, and De La Torre faces a maximum penalty of 10 years in federal prison for the remaining eight counts in the indictment. 

The charges are the result of an investigation by the U.S. Department of Health and Human Services, Office of Inspector General.  Assistant U.S. Attorney Zachary J. Corey is handling the prosecution.