DOJ says Tesar billed for expensive skin allografts that prosecutors claim were medically unnecessary, never provided, or repeatedly used on infected wounds and terminal patients whose conditions made meaningful healing unlikely, while Medicare allegedly paid more than $61 million.
WASHINGTON, DC — Federal prosecutors have accused Sarasota nurse practitioner Leigh Tesar and two Florida registered nurses of building an eighteen-month referral and billing operation that allegedly transformed vulnerable Medicare patients, expensive wound products, and purported clinical care into more than $118 million in claims.
The ten-count federal indictment, filed June 17, 2026, identifies Tesar as the central practitioner in an alleged arrangement involving Walter Presha Jr. and Koby Evans, while emphasizing that every charge remains an allegation requiring proof beyond a reasonable doubt.
Prosecutors say Medicare ultimately paid Tesar and Tesar Primecare more than $61 million on claims that allegedly covered medically unnecessary, ineligible, inaccurately represented, or entirely unperformed wound-care services, creating one of the most consequential Florida cases announced during the federal government’s 2026 health-care fraud crackdown.
The government further alleges that some allografts were placed on infected wounds, continued after treatments had demonstrably failed, or applied to terminally ill patients whose wounds were not expected to heal, circumstances that place patient welfare alongside financial loss at the center of the prosecution.
No court has determined that Tesar, Presha, or Evans committed the alleged conduct, and each defendant is entitled to challenge the government’s evidence, test its witnesses, dispute its interpretation of records, and maintain the presumption of innocence throughout every stage of the criminal proceedings.
Who Federal Prosecutors Charged
The indictment describes Tesar, then forty-four and living in Sarasota County, as a licensed nurse practitioner who enrolled individually with Medicare before reassigning her Medicare benefits to Tesar Primecare LLC, a Sarasota business registered as a single-specialty or multispecialty clinic or group practice.
Presha, then fifty-one and living in Manatee County, is identified as a licensed registered nurse who owned Universal Nursing and Wellness LLC and operated W.P. Enterprises, while Evans, then thirty-one and living in Hillsborough County, owned a company called Healing His Way LLC.
Prosecutors contend that Presha and Evans functioned as referral sources while nominally appearing to be sales representatives for an unnamed Pennsylvania allograft company, an arrangement the indictment characterizes as a disguise for compensation allegedly connected to Medicare beneficiaries steered toward Tesar’s wound-care services.
That distinction matters because legitimate product marketing and lawful clinical referrals can coexist within health care, yet federal law generally prohibits offering, paying, soliciting, or receiving remuneration intended to induce referrals for items or services reimbursable by a federal health-care program.
Why Wound Allografts Became the Alleged Billing Engine
The products discussed in the case are bioengineered skin substitutes, including certain amniotic membrane allografts made from human placental tissue, which clinicians may apply over qualifying open wounds to support closure or encourage skin growth when documented clinical conditions justify their use.
Medicare Part B can reimburse eligible providers for qualifying products and related services, but the indictment explains that payment depends upon medical reasonableness, medical necessity, accurate documentation, truthful representation of the treatment delivered, and compliance with federal rules prohibiting kickback-tainted transactions.
According to prosecutors, the alleged scheme exploited the unusually high value of certain products by selecting allografts to maximize revenue, recruiting patients whose wounds created repeated billing opportunities, and linking referral compensation to the product costs ultimately invoiced through Medicare claims.
The accusation is therefore broader than a dispute over clinical judgment, because the government says the defendants coordinated referrals, concealed financial incentives, falsified medical records, waived patient obligations improperly, and submitted claims for applications that sometimes never occurred.
An Alleged Search for Medicare Patients with Wounds
Prosecutors say Tesar worked with Presha, Evans, and other purported sales representatives to identify Medicare beneficiaries with wounds, enabling Primecare to purchase allografts from the unnamed supplier, apply those products through Tesar’s practice, and seek federal reimbursement for the resulting services.
One overt act quoted in the indictment involves a June 2024 text in which Tesar allegedly told Presha she could move from room to room looking for wounds, before adding that the approach “might be illegal, but oh well.”
That message will likely receive substantial attention because prosecutors may present it as evidence of intent, although defense lawyers can contest its context, meaning, authenticity, relevance, or relationship to particular claims when the government eventually seeks to introduce it in court.
The indictment also alleges that beneficiaries were encouraged to begin or continue expensive treatments through misrepresented costs, improper copayment waivers, free medical supplies, and costly gifts that included jewelry and a leather recliner, benefits prosecutors describe as unlawful inducements rather than incidental assistance.
For Medicare, beneficiary cost-sharing requirements serve more than an accounting function, because unauthorized waivers can remove a patient’s reason to question price or necessity, while gifts may distort voluntary treatment decisions and conceal the financial machinery motivating a referral network.
Infected Wounds, Terminal Patients, and Unperformed Care
The government alleges that Tesar applied allografts without first attempting or confirming conservative treatment, continued applications when wounds were already healing through less intensive care, and persisted after clinical results allegedly showed that repeated grafting was not producing an appropriate response.
Other allegations describe applications to infected wounds and wounds unlikely to heal because patients were terminally ill, while prosecutors additionally claim that product selection reflected reimbursement potential and profit rather than individualized clinical need, suitability, or realistic therapeutic benefit.
Those claims make medical evidence especially important, because jurors may ultimately hear competing interpretations from wound-care specialists, reimbursement experts, treating professionals, and documentation reviewers concerning infection, prognosis, prior conservative treatment, product choice, treatment frequency, and reasonable expectations for healing.
The indictment separately alleges that Medicare received claims for allograft applications that were never rendered, converting part of the case from an argument about unnecessary treatment into a more direct accusation that federal money was requested for services prosecutors say did not happen.
Medical Records Under Scrutiny
Prosecutors contend that Tesar and others falsified patient files so the allograft applications appeared medically reasonable, necessary, and compliant, allegedly documenting treatments that were not rendered, attributing prior conservative care to Tesar, backdating wound documentation, and reporting conditions designed to justify reimbursement.
Clinical records will consequently become a critical evidentiary battleground, since the government must connect disputed entries to knowing conduct while the defense may examine workflow problems, delegated documentation, billing contractors, template language, coding practices, incomplete records, and ordinary mistakes that do not establish criminal intent.
Medicare claims contain beneficiary identifiers, service descriptions, billing codes, treatment dates, and rendering-provider information, meaning investigators can compare submissions against clinical notes, product orders, supplier invoices, bank transfers, electronic communications, facility records, patient accounts, and testimony from people present during purported treatments.
Data comparisons can expose improbable treatment patterns across many beneficiaries, but criminal liability still depends upon admissible evidence addressing each defendant’s knowledge and participation, rather than statistics alone or the mere fact that a provider generated unusually high reimbursements.
Five Health-Care Fraud Counts Detail Specific Claims
Counts one through five charge Tesar with health-care fraud through five representative Medicare claims involving beneficiaries identified only by initials, thereby protecting patient identities while specifying approximate service dates, submission dates, billed amounts, and payments that prosecutors say executed the broader alleged scheme.
The listed claims range from approximately $288,350 billed for one beneficiary to approximately $1.11 million billed for another, and together the five examples total approximately $3.96 million submitted and approximately $2.82 million paid by Medicare.
The government says those claims falsely represented that the products and services were medically necessary, eligible for reimbursement, delivered as described, and untainted by kickbacks, while the defense remains free to dispute any element associated with each transaction.
By identifying discrete claim executions, prosecutors can present detailed patient-level evidence alongside their broader financial narrative, giving jurors concrete episodes through which to evaluate whether an alleged system of referrals, documentation, product selection, and billing amounted to intentional fraud.
The Alleged Kickback Structure
Count six charges all three defendants with conspiring between approximately May 2024 and November 2025 to defraud the United States and to offer, pay, solicit, and receive kickbacks connected with Medicare-reimbursed wound-care products and services.
The indictment alleges that Presha, Evans, and others signed sham sales agreements with the Pennsylvania company even though their true function was supplying Tesar with Medicare beneficiary referrals, after which the company allegedly transmitted compensation associated with allograft purchases and resulting billings.
In September 2024, prosecutors say Tesar sent Presha messages identifying more than $4.06 million in total invoices and calculating twenty percent as $813,925, communications the government may use to argue that referral compensation was directly linked to product volume and value.
Later messages allegedly discussed a product costing $2,000 per square centimeter, compared with another priced at $1,591, while Tesar purportedly told Presha that his return would be significantly higher and expressed an intention to switch patients to the more expensive option.
In another exchange during April 2025, Tesar allegedly warned Evans not to disclose that she had discussed money, adding that she was not supposed to discuss financial details with the purported sales representatives, language prosecutors characterize as evidence of concealment.
The indictment identifies two August 15, 2025, transfers as substantive kickback transactions, alleging that approximately $397,570 moved from the supplier’s account to Presha’s W.P. Enterprises account and approximately $10,998 moved to Evans’s Healing His Way account.
Counts seven and eight accuse Tesar of offering and paying those kickbacks, while counts nine and ten accuse Presha and Evans of receiving the corresponding payments, creating mirrored allegations addressing both sides of the disputed financial transactions.
$118 Million Billed, More Than $61 Million Paid
Across the alleged eighteen-month operation, prosecutors say Tesar and others caused more than $118 million in claims for wound-care products and services that were unnecessary, ineligible, misrepresented, unperformed, or obtained through kickbacks, with Medicare paying more than $61 million to Tesar and Primecare.
The difference between amounts billed and paid is important because federal reimbursement systems frequently adjust, reduce, deny, or otherwise modify submitted charges, yet attempted fraudulent claims may remain relevant even when Medicare does not release every dollar requested.
Authorities announced the seizure of approximately $11.8 million in assets connected with the matter, including money from bank and investment accounts, while the indictment seeks forfeiture of proceeds allegedly traceable to the charged offenses and substitute property when directly traceable assets are unavailable.
The forfeiture allegations identify approximately $61.63 million as proceeds Tesar allegedly obtained, approximately $3.19 million attributed to Presha, and approximately $263,223 attributed to Evans, although those figures remain disputed allegations rather than judicial findings of ownership or criminal derivation.
Prosecutors further allege that fraud proceeds financed extravagant 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.
Such purchases can provide a compelling courtroom narrative, but luxury spending is not independently proof of fraud, so the government must still demonstrate that charged proceeds came from criminal conduct and that each defendant possessed the knowledge required by the relevant statutes.
An Audit and an Alleged Ownership Change
Following a Medicare audit, prosecutors say Tesar removed her name as Primecare’s owner in Florida corporate records while continuing to exercise ownership and managerial control, an action the government alleges was intended to evade scrutiny as disputed claims continued.
The defense may offer an alternative explanation for any corporate filing or management structure, but prosecutors are likely to connect the ownership change with audit timing, later claims, financial control, internal communications, and operational decisions in an effort to establish consciousness of wrongdoing.
Audits often become turning points in health-care fraud investigations because they preserve disputed documentation, reveal how providers respond to compliance warnings, identify individuals controlling billing and finances, and establish whether questioned practices continued after regulators raised concerns.
Part of a Historic National Enforcement Action
The Tesar case emerged during a nationwide operation that federal officials described as the Justice Department’s largest coordinated health-care fraud takedown, encompassing hundreds of defendants, billions of dollars in alleged fraudulent claims, licensed professionals, marketers, corporate operators, and multiple specialized enforcement teams.
Contemporaneous reporting from WUSF and Health News Florida placed the Sarasota allegations among numerous Florida cases and broader prosecutions involving wound products, laboratory services, medical equipment, COVID-19 tests, genetic testing, and other areas where high-volume claims attracted federal investigators.
Federal authorities increasingly use data analytics to compare provider behavior, identify sudden billing spikes, measure utilization against peer groups, and trace networks linking beneficiaries, practitioners, suppliers, marketers, bank accounts, and claims across districts before investigators execute seizures or seek charges.
Wound-care reimbursement has become especially vulnerable to scrutiny because expensive products billed by surface area can generate enormous claim values from a comparatively small group of patients, creating incentives for excessive sizing, repeated applications, aggressive referrals, or products selected primarily for price.
Legitimate clinicians and suppliers remain essential to patients with complex wounds, however, and enforcement cases should not obscure the medical value of properly selected allografts delivered after appropriate conservative treatment, documented accurately, monitored carefully, and billed without prohibited compensation arrangements.
What the Case Means for Patients and Providers
For beneficiaries, the allegations illustrate how improper incentives can influence intimate treatment decisions, particularly when elderly, disabled, chronically ill, or terminally ill patients depend upon professionals to explain whether a procedure offers meaningful clinical value and whether continued intervention is justified.
Even when Medicare absorbs most direct costs, a beneficiary can face copayments, physical discomfort, infection risks, disrupted hospice priorities, repeated visits, and confusion about treatment, while the public program loses money intended for medically appropriate care.
For providers, the indictment underscores the danger of percentage-based referral compensation, sales agreements disconnected from genuine marketing work, routine copayment waivers, high-value gifts, documentation written backward from reimbursement criteria, and treatment selection driven by product economics instead of patient need.
Compliance programs should require independent medical-necessity review, transparent vendor relationships, defensible product selection, documented conservative care, careful infection assessment, accurate treatment measurements, verified product application, and financial controls capable of flagging referral payments tied to federal program business.
Organizations also need channels through which nurses, billers, clinicians, patients, and vendors can report concerns without retaliation, because questionable practices can expand rapidly when revenue grows faster than compliance staffing and employees believe management will ignore warnings.
A Criminal Case, not a Final Judgment
An indictment records a grand jury’s determination that probable cause supports criminal charges, but it does not establish guilt, resolve disputed medical questions, authenticate every communication, determine whether witnesses are credible, or prove that a particular defendant knowingly joined an unlawful agreement.
To obtain convictions, prosecutors must prove the required elements beyond a reasonable doubt, while defense counsel can challenge searches, seizures, expert opinions, billing interpretations, patient testimony, financial tracing, electronic evidence, and the government’s characterization of relationships among the defendants and unnamed participants.
The public should therefore distinguish carefully between the indictment’s detailed allegations and adjudicated facts, especially when discussing Tesar, Presha, Evans, Primecare, or associated businesses whose reputations may be affected long before motions, plea negotiations, or any trial establishes an outcome.
That distinction also belongs at the center of responsible crisis communications planning, where accuracy, legal coordination, consistent messaging, and respect for court proceedings matter more than speculation, unsupported counterclaims, or attempts to overwhelm verifiable reporting with misleading narratives.
Longer-term reputation rebuilding strategies must similarly remain grounded in truthful information and documented outcomes, because criminal allegations create durable search records while acquittals, dismissals, settlements, cooperation, restitution, or convictions can materially change the responsible public account.
What Happens Next
The prosecution will proceed in the Middle District of Florida, where discovery, evidentiary disputes, pretrial motions, expert analysis, possible plea discussions, and trial preparation may test the government’s claim that clinical decisions, referral payments, records, and Medicare submissions formed a unified fraudulent scheme.
The government’s forfeiture effort will develop alongside the criminal case, requiring courts to determine whether specified assets represent traceable proceeds, whether third parties assert legitimate interests, and whether substitute property may be reached if directly connected funds cannot be located.
Medicare administrators and other insurers may also review related claims, providers, products, and referral relationships, while licensing authorities can conduct separate proceedings under standards and burdens that differ from the criminal case and do not necessarily depend upon a conviction.
Patients whose treatment appears in investigative files may be contacted as witnesses or asked to authorize records, although their privacy remains important and the indictment’s use of initials demonstrates why coverage should avoid exposing personal medical information unnecessary to understanding the public allegations.
The Larger Warning from the Leigh Tesar Indictment
At its core, the case alleges that a legitimate therapeutic category became the vehicle for a referral-driven business model in which product price, reimbursement, and secret compensation displaced individualized wound care, while inaccurate records allegedly made the resulting claims appear compliant.
Whether prosecutors can prove that account will depend upon evidence tested through the adversarial process, yet the indictment already offers regulators and health-care organizations a detailed map of the vulnerabilities investigators are examining across the expanding skin-substitute marketplace.
Those vulnerabilities include unverified conservative treatment, infected or nonhealing wounds, repeated applications without improvement, terminal patients with unrealistic healing prospects, expensive products chosen for margin, sham sales contracts, percentage-based referral payments, gifts, waived copayments, altered records, and claims for services never delivered.
For taxpayers and beneficiaries, the alleged scale is striking: more than $118 million billed, more than $61 million paid, and approximately $11.8 million seized in a single Florida matter arising from roughly eighteen months of wound-care activity.
For Tesar, Presha, and Evans, however, the decisive questions remain ahead, because only evidence presented or admitted in court, evaluated under constitutional protections and the beyond-a-reasonable-doubt standard, can determine whether the government’s extraordinary allegations become proven criminal facts.
