Sandra Jackson, a former Delaware nurse practitioner now living in Florida, agreed to pay $38,000 to settle federal allegations that she electronically signed hundreds of medically unnecessary Medicare orders for genetic tests and durable medical equipment. The U.S. Attorney’s Office for the District of Delaware announced the civil False Claims Act settlement on July 7, 2025. Medicare had paid roughly $521,792 on the orders she approved.1U.S. Department of Justice. Former Delaware Nurse Practitioner Resolves Health Care Fraud Allegations
What Jackson Was Alleged to Have Done
Between September 2018 and April 2019, Jackson digitally signed hundreds of pre-populated orders for genetic testing and durable medical equipment for Medicare beneficiaries in Delaware, according to the Department of Justice. She had never physically examined those patients and had no pre-existing provider-patient relationship with any of them.1U.S. Department of Justice. Former Delaware Nurse Practitioner Resolves Health Care Fraud Allegations
A statement of facts Jackson signed as part of the settlement describes the mechanics. She logged into a telehealth provider’s online portal, pulled up patient information and medical histories, and used that data to generate orders that she then reviewed and signed electronically. She reportedly signed some of them “within seconds of opening them.” She provided no follow-up care. In total, the orders covered more than 300 beneficiaries she never treated, evaluated, or met in person.2WHYY. Delaware Doctor Accused Medicare Fraud
What the Settlement Requires
Jackson, 72, agreed to pay $38,000 to resolve the False Claims Act allegations.3U.S. Department of Justice. National Health Care Fraud Case Summaries That figure is a small fraction of what Medicare paid out on the orders she approved. As is standard in civil resolutions of this kind, the agreement states that the claims are allegations only and that there has been no determination of liability.1U.S. Department of Justice. Former Delaware Nurse Practitioner Resolves Health Care Fraud Allegations
No parallel criminal charges against Jackson have been publicly reported. The DOJ press release and the related enforcement records describe the matter solely as a civil resolution.4HHS Office of Inspector General. Former Delaware Nurse Practitioner Resolves Health Care Fraud Allegations
An Earlier Medicare Billing Revocation
The civil settlement was not Jackson’s first federal consequence tied to this period. In July 2022, an Administrative Law Judge upheld a decision by the Centers for Medicare and Medicaid Services to revoke Jackson’s Medicare billing privileges and impose a ten-year reenrollment bar. The revocation was based on her failure to maintain and produce medical records for 15 Medicare beneficiaries for whom she had ordered durable medical equipment. Jackson had provided telehealth services for roughly five months, from November 2018 through April 2019, and had not retained the seven years of documentation federal regulations require.5U.S. Department of Health and Human Services. ALJ Decision CR6122
The ALJ decision also noted that Jackson had moved from the Delaware–Pennsylvania area to Florida without updating her correspondence address in the CMS database, which contributed to her not receiving the initial requests for those records.5U.S. Department of Health and Human Services. ALJ Decision CR6122
Her Nursing License Today
Despite the federal actions, Jackson’s Florida nursing license remains active. The Florida Department of Health practitioner profile lists her Advanced Practice Registered Nurse license as “Clear/Active” with an expiration date of July 31, 2028. The profile reports no criminal offenses, no Medicaid sanctions, and no final disciplinary actions by specialty boards or licensing agencies within the last ten years. She also holds registered nurse licenses in Delaware and Pennsylvania.6Florida Department of Health. Practitioner Profile – Sandra Fowler Jackson
State nursing boards sometimes act on a separate timeline from federal enforcement, and a civil settlement carrying no admission of liability does not automatically trigger a state disciplinary proceeding.
How the Scheme Worked
Jackson’s conduct fits a pattern federal prosecutors have targeted since 2019, when the DOJ charged dozens of defendants tied to networks of telemedicine companies, genetic testing labs, and telemarketing operations. In that model, upstream operators generate pre-populated doctors’ orders and route them to licensed practitioners for a signature, often for patients the practitioner never examines. Laboratories then bill Medicare for tests that were not medically necessary.7U.S. Department of Justice. Federal Law Enforcement Action Involving Fraudulent Genetic Testing
The DOJ alleged that Jackson’s conduct followed that playbook: orders pre-populated by others, patients she never met, information pulled from a telehealth portal. The government has not publicly identified the specific telemedicine company or upstream organizers that supplied her with the orders.
Enforcement in this area has continued to expand. On June 30, 2025, the DOJ announced its largest health care fraud takedown to date, charging 324 defendants across 50 federal districts in schemes involving an alleged $14.6 billion in intended losses, with 49 defendants charged in connection with more than $1.17 billion in fraudulent telemedicine and genetic testing claims.8U.S. Department of Justice. National Health Care Fraud Takedown Results in 324 Defendants Charged