Indictment says APRN billed Medicare for allografts prosecutors claim were unnecessary, unprovided, or ordered for terminal patients, while two nurses allegedly received referral kickbacks during an 18-month Florida operation that generated more than $61 million in federal payments
WASHINGTON, DC, August 26, 2026 — Federal prosecutors have accused Sarasota nurse practitioner Leigh Tesar of directing a sprawling Medicare wound-care operation that allegedly generated more than $118 million in claims for costly allografts, including treatments authorities contend were medically unnecessary, never furnished, or applied to patients unlikely to heal.
The federal grand jury indictment, filed June 17 in the Middle District of Florida, names Tesar alongside registered nurses Walter Presha Jr. and Koby Evans, and it presents ten criminal counts built around health care fraud, referral kickbacks, false documentation, and alleged efforts to evade Medicare scrutiny.
In its official announcement of the Florida charges, the Justice Department said the case formed part of the 2026 National Health Care Fraud Takedown, an enforcement initiative spanning dozens of federal districts and targeting alleged schemes involving billions of dollars in submitted claims.
Prosecutors say Medicare received more than $118 million in claims connected to the defendants’ alleged wound-care activities, paid Tesar and Tesar Primecare more than $61 million, and supported the government’s seizure of approximately $11.8 million from accounts investigators linked to purported proceeds.
Those figures establish the financial scale of the prosecution, yet the indictment’s most consequential allegations concern elderly, disabled, chronically ill, and terminally ill beneficiaries whose wounds allegedly became opportunities for high-value billing rather than occasions for conservative, medically supported, and carefully documented treatment.
How prosecutors say the alleged operation worked
According to the indictment, Tesar was a licensed nurse practitioner who enrolled as an individual Medicare provider before reassigning her benefits to Tesar Primecare, a Florida business registered with Medicare as a single-specialty or multispecialty clinic or group practice in Sarasota.
The charging document describes an unnamed Pennsylvania company that marketed and sold wound-care products, including placental-tissue allografts, while operating under a fictitious business name and maintaining agreements with Presha, Evans, and other people presented as independent sales representatives.
Presha allegedly owned Universal Nursing and Wellness and registered another business name called W.P. Enterprises, while Evans allegedly owned Healing His Way, giving prosecutors a series of businesses and bank accounts through which they say referral-related payments moved.
Federal authorities contend those sales arrangements were shams because Presha, Evans, and other purported representatives were allegedly recruited to locate Medicare beneficiaries with wounds and refer those patients to Tesar, rather than perform conventional product marketing independent of clinical decision-making.
The indictment alleges Tesar ordered costly allografts from the distributor, applied or purportedly applied those products to beneficiary wounds, and then caused Primecare to submit Medicare claims whose reimbursement values created an unusually powerful financial incentive throughout the alleged referral network.
Prosecutors further accuse Tesar and others of encouraging beneficiaries to begin or continue expensive allograft treatment by misstating costs, unlawfully waiving required copayments, and providing free medical supplies or other valuable inducements, allegedly including jewelry and a leather recliner.
The government says Tesar offered or caused payments to purported sales representatives, health care providers, and others in exchange for beneficiary referrals, transforming what appeared on paper to be sales compensation into alleged remuneration tied directly to federally reimbursed medical business.
Investigators also claim product selection was driven by profit rather than patient need, an allegation that places the distributor’s pricing, Primecare’s purchasing records, the dimensions of each wound, and Medicare’s payment calculations at the center of the anticipated evidentiary dispute.
Why wound allograft billing receives close scrutiny
Wound allografts described in the indictment are bioengineered skin substitutes, including products made from human placental tissue, that may be placed over open wounds to promote closure or skin growth when accepted clinical conditions and Medicare coverage requirements are satisfied.
Medicare Part B can reimburse qualified providers for medically necessary services and covered products, but the indictment emphasizes that payment depends upon truthful claims, accurate clinical records, services furnished as represented, and transactions untainted by prohibited kickbacks or bribes.
In Florida, First Coast Service Options acted as the Medicare administrative contractor responsible for processing relevant Part B claims, while its local coverage policies described when continuing wound treatment and skin-substitute applications could qualify as reasonable, necessary, and reimbursable.
For diabetic foot ulcers and venous leg ulcers, the cited policy generally required at least four weeks of completed and documented conservative care, including measures addressing infection, pressure, debridement, drainage, and underlying medical factors before covered skin substitutes could become appropriate.
The policy also tied continued treatment to documented improvement, discouraged switching products during a defined treatment course, and excluded repeated applications following unsuccessful treatment or applications made while uncontrolled underlying conditions and active infections undermined expected healing.
Against that regulatory backdrop, prosecutors allege Tesar applied allografts without attempting or confirming sufficient conservative care, continued applications after wounds were not responding, treated infected wounds, and selected particular products solely to maximize profit instead of therapeutic benefit.
The indictment’s reference to terminally ill patients is especially stark because the government contends some wounds could not heal given the beneficiary’s condition, making repeated high-cost applications allegedly incompatible with the patient’s realistic restoration potential and Medicare’s medical-necessity framework.
Medical records and five representative claims
Prosecutors accuse Tesar and unidentified collaborators of falsifying medical files so applications would appear compliant, including by recording treatments that allegedly never occurred, reporting earlier wound documentation that did not exist, and misstating patient conditions to justify expensive allografts.
The charging document further alleges that records falsely represented that Tesar personally administered prior conservative treatment, a detail that could matter because Medicare contractors rely heavily on contemporaneous clinical documentation when deciding whether an advanced product qualifies for reimbursement.
In other instances, the government claims Medicare was billed for allografts or application services that were never rendered, meaning the prosecution encompasses both disputes over clinical necessity and the more elemental accusation that claimed products never reached identified patients.
Five substantive health care fraud counts identify anonymized beneficiaries and claims totaling approximately $3.96 million billed and $2.82 million paid, with individual billed amounts ranging from $288,350 to more than $1.11 million for dates of service between October 2024 and August 2025.
Those five transactions represent charged executions rather than the entire alleged loss universe, while the broader narrative says Tesar and others caused more than $118 million in submissions and obtained more than $61 million during the full period under investigation.
Prosecutors additionally allege that after a Medicare audit began, Tesar removed her name as Primecare’s owner in Florida corporate records while continuing to exercise ownership and managerial control, an action the government characterizes as an attempt to avoid scrutiny over subsequent claims.
The alleged scheme ran from approximately May 2024 through November 2025, a concentrated eighteen-month window during which investigators say patient referrals, product purchases, medical documentation, electronic claims, distributor payments, and personal expenditures created a constructible financial and clinical trail.
That compressed timeline may allow both sides to compare wound photographs, visit notes, product invoices, bank deposits, communications, claim-submission dates, and reimbursement decisions with unusual precision, although the meaning and reliability of each record remain questions for adversarial litigation.
Messages and payments described by the indictment
Among the overt acts cited by prosecutors is a June 2024 message in which Tesar allegedly told Presha she could move through rooms searching for wounds before acknowledging possible illegality, language the government will likely present as evidence concerning knowledge and intent.
Another alleged exchange from September 2024 referenced invoices totaling approximately $4.07 million and calculated twenty percent as roughly $813,925, supporting the prosecution’s theory that purported sales compensation tracked the reimbursable value of products associated with referred beneficiaries.
In January 2025, the indictment says Tesar discussed a product cost of $2,000 per square centimeter instead of $1,591 and described the resulting twenty-percent share, later indicating an intention to switch patients toward the product producing the larger financial return.
An April 2025 message allegedly cautioned Evans not to discuss money directly, while a July email allegedly identified products, patients, payments, and associated representatives so the unnamed distributor could calculate and transmit compensation the government labels illegal kickbacks.
The indictment identifies two August 15, 2025 deposits as separate kickback transactions, alleging approximately $397,570 moved from the distributor’s account to an account associated with Presha and approximately $10,998 moved to an account associated with Evans.
Those communications and transfers do not independently establish every element of the charged offenses, but prosecutors are expected to combine them with testimony, Medicare records, medical files, contracts, and bank evidence to argue that the arrangements were knowingly unlawful.
Luxury spending, seizures, and proposed forfeiture
The government alleges proceeds supported lavish personal spending, including more than $215,000 for Tampa Bay Buccaneers tickets and a luxury suite at Raymond James Stadium, together with more than $400,000 spent on fine art during the charged period.
Court documents list four major seizures associated with Tesar, including approximately $1.01 million from a Bank of America account, $8 million and approximately $1.91 million from a Fidelity Investments account, and about $867,862 from a Cogent Bank account.
The indictment seeks forfeiture of approximately $61.63 million attributed to Tesar, approximately $3.19 million attributed to Presha, and approximately $263,223 attributed to Evans, while also allowing prosecutors to pursue substitute property if directly traceable assets cannot be located or divided.
Asset seizure and a forfeiture allegation are not equivalent to a final forfeiture judgment, because ownership, traceability, third-party interests, statutory authority, and the relationship between particular property and proven offenses may remain contested throughout the federal proceeding.
Ten counts and three defendants
Counts one through five accuse Tesar of health care fraud and aiding or abetting specific executions of the alleged scheme, with prosecutors identifying individual claim dates, service dates, beneficiaries represented by initials, billed totals, and amounts Medicare allegedly paid.
Count six charges Tesar, Presha, and Evans with conspiring to defraud the United States and to offer, pay, solicit, or receive health care kickbacks, while describing alleged overt acts that span communications, referrals, pricing discussions, and distributor-funded transfers.
Counts seven and eight accuse Tesar of offering and paying health care kickbacks connected to the two August deposits, whereas counts nine and ten, respectively, accuse Presha and Evans of receiving payments in exchange for referring Medicare beneficiaries.
Local reporting based on federal court records says all three defendants were arrested and released on June 18, with Tesar placed on a $1 million bond, Presha on a $250,000 bond, and Evans on a $100,000 bond while the prosecution proceeds.
Every charge remains an allegation, and Tesar, Presha, and Evans are presumed innocent unless prosecutors prove guilt beyond a reasonable doubt through admissible evidence and a guilty verdict, or unless a defendant knowingly chooses to enter a guilty plea.
A major case within a nationwide takedown
The Justice Department announced the Tesar prosecution alongside a nationwide operation charging 455 defendants, including ninety physicians and other licensed professionals, in alleged health care fraud and opioid-abuse schemes involving more than $6.5 billion in claims and significant patient harm.
Federal officials said the coordinated initiative reached fifty-six judicial districts across forty-five states and territories, while participating agencies seized more than $182 million in cash, real estate, vehicles, jewelry, and other assets across the larger collection of cases.
The department credited advanced data analytics with helping investigators identify unusually costly providers, concentrated billing patterns, suspect referral relationships, and other anomalies, illustrating how claims information can lead authorities from national reimbursement trends toward specific clinical files and bank accounts.
Within that national picture, the Tesar matter stands out because its alleged billing exceeded $118 million in only eighteen months and because prosecutors have placed licensed nursing professionals, terminal patients, sham marketing arrangements, and expensive allografts at the narrative’s center.
The case therefore raises two distinct public interests, since taxpayers need confidence that limited Medicare resources purchase eligible care, while medically vulnerable beneficiaries need assurance that treatment decisions reflect healing prospects and informed consent rather than unusually lucrative reimbursement formulas.
What the case could test in court
If the case advances toward trial, prosecutors will likely emphasize claim data, payment records, product prices, referral communications, patient charts, and the defendants’ alleged statements, while defense lawyers may challenge intent, clinical interpretations, witness credibility, loss calculations, and the characterization of commercial agreements.
Medical necessity can require patient-specific analysis rather than retrospective generalization, so contested wounds, underlying conditions, conservative therapies, product choices, documentation practices, and the knowledge available to each clinician at the time of treatment could be examined in exceptional detail.
The kickback counts present a related but separate inquiry concerning whether compensation was knowingly exchanged for referrals covered by a federal program, rather than paid for legitimate marketing or sales services documented through commercially reasonable and legally compliant arrangements.
Forfeiture litigation may also become significant because the indictment identifies substantial account seizures and broad proceeds calculations, while defendants and potential third parties can dispute whether particular funds constitute traceable proceeds, legitimate earnings, commingled property, or assets subject to substitute-forfeiture rules.
No indictment decides those questions, because a grand jury evaluates whether probable cause supports criminal charges without the full adversarial testing of trial, cross-examination, defense evidence, judicial instructions, and the constitutional reasonable-doubt standard.
The reputational consequences of an unresolved indictment
Long before a verdict, a major Medicare fraud indictment can dominate search results, reshape professional relationships, trigger licensing and contracting reviews, and create a permanent digital record in which preliminary allegations are repeatedly summarized, while later procedural developments receive little attention.
For organizations or professionals facing comparable publicity, well-planned crisis public relations management generally requires factually accurate statements, coordinated legal review, disciplined spokesperson protocols, and prompt corrections, while avoiding rhetoric that could prejudice litigation or misrepresent unresolved allegations as established truth.
Over a longer horizon, lawful reputation rebuilding strategies may emphasize accurate updates, authoritative documentation, transparent corrective measures, and durable public-interest content, rather than attempts to erase legitimate reporting or conceal material facts from patients, regulators, counterparties, and courts.
Nothing in the public charging documents indicates that Amicus International Consulting represents any defendant in this case, and discussion of communications or reputation principles is included solely to explain the broader consequences that frequently follow heavily indexed federal accusations.
Responsible coverage should preserve the distinction between allegation and proof, identify the government’s evidence without adopting prosecutorial conclusions, acknowledge the defendants’ presumption of innocence, and update readers if later rulings, pleas, dismissals, acquittals, convictions, or forfeiture judgments materially change the record.
For now, United States v. Leigh Tesar, Walter Presha Jr., and Koby Evans remains a pending federal prosecution whose extraordinary billing totals and disturbing patient-care allegations will be tested through motions, evidence, and courtroom procedure rather than settled by the indictment’s forceful language alone.
