Find Corporate Waste

Tag: Texas

  • Seven Men Arrested in $205K COVID Relief Fraud Case

    Seven Men Arrested in $205K COVID Relief Fraud Case

    Federal prosecutors announced that seven Las Vegas men have been arrested and indicted in connection with allegedly fraudulent COVID-19 relief loan applications.

    According to the U.S. Attorney’s Office for the District of Nevada⁠, the defendants are accused of submitting false information and fake documentation to obtain funds through the Small Business Administration’s Paycheck Protection Program and Economic Injury Disaster Loan program. The alleged fraudulent proceeds totaled $205,639.

    The defendants named by DOJ are Elias Santino Acereto, Sheyland Juakeen Barnett, James Sean Freeman II, Yves Garry Harrison-Pierre, Tyrone Tatrice Johnson, Marcus Dushun McMillian-Bonner, and Nathan Jeffry Scott. Six defendants were charged with one count of wire fraud, while Freeman was charged with two counts.

    The SBA Office of Inspector General⁠ said the arrests followed coordinated law enforcement actions in Nevada, Arizona, and Texas involving the FBI, SBA-OIG, Las Vegas Metropolitan Police Department, and North Las Vegas Police Department.

    For Find Corporate Waste⁠, the case is another reminder that COVID-era relief enforcement remains active. Even smaller-dollar PPP and EIDL cases can expose broader weaknesses in application screening, identity verification, and post-payment review.

  • $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    Community Care Health Network LLC, doing business as Matrix Medical Network, DPN USA, doing business as HealthFair, and Shahriah “James” Ekbatani agreed to pay $56.5 million to resolve False Claims Act allegations over unsupported Medicare Advantage diagnosis codes, the DOJ announced.

    Matrix will pay $36.5 million, HealthFair will pay $5 million, and Ekbatani will pay $15 million.

    The DOJ alleged the defendants caused Medicare Advantage Organizations to submit false or invalid diagnosis codes to CMS, increasing risk-adjusted taxpayer payments.

    Matrix allegedly used in-home assessments to report unsupported conditions. HealthFair allegedly used mobile assessment buses to report unsupported diagnoses under Ekbatani’s direction.

    The whistleblowers will receive major awards. Former Matrix employee Nancy Cahill will receive $7.3 million. Former HealthFair chief medical officer Dr. Robert Oristaglio Jr. will receive $3.6 million.

    Insiders with knowledge of unsupported diagnosis coding, chart-review pressure, mobile assessments, or Medicare Advantage billing failures may have information relevant to public-fraud enforcement.

    Find Corporate Waste helps protect insiders while exposing fraud, waste, and abuse in taxpayer-funded programs.

  • Texas Physician to Pay $3.5M for Fraudulent COVID Billing Scheme Targeting Uninsured Program

    The U.S. Attorney’s Office for the Eastern District of Texas announced that Dr. Samad Khan has agreed to pay $3.5 million to resolve allegations of fraudulent billing to the federal government—thanks to a federal investigation targeting misuse of emergency pandemic funds.

    Dr. Samad Khan, owner of SK Primary Care, PLLC, was accused of submitting false claims to the COVID-19 Uninsured Program, which reimbursed providers for testing and treatment of uninsured individuals during the public health emergency. From April 2020 to October 2021, Khan allegedly billed for evaluation and management (E/M) services that were never performed.

    Under the Current Procedural Terminology (CPT) coding system, higher-level E/M services (CPT 99202–99205, 99212–99215) are intended to reflect complex medical care requiring direct attention by a physician or qualified healthcare provider.

    Patients at Khan’s walk-up and drive-through COVID test sites were allegedly not evaluated by any licensed providers—only medical assistants conducted nasal swabs, a service properly billed under CPT 99211.

    Khan allegedly submitted approximately 400,000 claims under higher-level codes and was the sole rendering provider listed. Many of the claims were for duplicated visits, with one charge for the test and another for delivering results—often via automated message, not through medical consultation.

    “These were not medical appointments,” said Acting U.S. Attorney Jay R. Combs. “Patients received a nasal swab and later got a text message with their results. Yet the government was billed for comprehensive office visits.”

    According to the complaint, Khan, in coordination with SK Primary Care’s management company, used inflated codes to maximize reimbursement from the Uninsured Program. The scheme generated millions in overpayments—diverting public funds meant to support pandemic response for those without health insurance.

    Find Corporate Waste is tracking a growing number of fraud cases involving COVID-19 relief funds—an urgent reminder that emergency spending, no matter how critical, requires oversight. Whistleblowers and investigators remain essential to protecting the integrity of public programs.