Florida NP and Two Nurses Charged in $118 Million Medicare Wound Care Fraud Scheme

Image source: Sarasota Herald-Tribune

A Sarasota nurse practitioner and two Tampa Bay-area nurses have been charged in an alleged $118 million Medicare wound care fraud scheme, federal prosecutors announced — one of the largest individual cases in this year’s national health care fraud takedown.

According to the federal indictment, nurse practitioner Leigh Tesar, 44, of Sarasota, allegedly billed Medicare for unnecessary and expensive wound allografts, while nurses Walter Presha Jr., 51, of Ellenton, and Koby Evans, 31, of Apollo Beach, allegedly accepted kickbacks for steering patients her way. Prosecutors say Medicare was billed roughly $118 million over an 18-month period and paid out approximately $61 million on the claims. Investigators have seized approximately $11.8 million in assets tied to the case.

The charges are allegations. All three defendants are presumed innocent unless and until proven guilty in court. Tesar, Presha, and Evans were arrested June 18 and released the same day — Tesar on $1 million bond, Presha on $250,000 bond, and Evans on $100,000 bond.

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Prosecutors allege Tesar targeted Medicare patients, including some whose wounds were infected, unlikely to heal, or did not require the expensive grafts. In certain instances, Medicare was billed for allografts that were never applied to patients at all.

The alleged scheme went beyond billing. The indictment alleges that Tesar and others induced Medicare beneficiaries to undergo and continue expensive wound allograft treatment by misrepresenting costs, illegally waiving co-payments, and providing illegal inducements including gifts such as jewelry and a leather recliner. Prosecutors also allege that Tesar and others falsified patient medical records to make the allografts appear medically reasonable and necessary.

Federal authorities describe the operation as a coordinated kickback-and-billing scheme rather than legitimate patient care. Prosecutors say the proceeds funded a lavish lifestyle, including more than $215,000 spent on Tampa Bay Buccaneers tickets and a luxury box suite at Raymond James Stadium, and more than $400,000 on fine art.

Tesar faces charges of conspiracy to defraud the United States, conspiracy to pay and receive health care kickbacks, health care fraud, and payment of health care kickbacks. Presha and Evans face the conspiracy charges and receipt of health care kickbacks.

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This case is one piece of a much larger federal enforcement action. As Nurse.org reported this week, the DOJ charged 455 defendants, including 90 doctors and other licensed medical professionals, in connection with more than $6.5 billion in alleged health care fraud — the largest coordinated health care fraud takedown the agency says it has ever run.

Assistant Attorney General Colin McDonald said the cases “allege more than the theft of taxpayer dollars. Many allege the theft of human dignity,” adding that “our sick, needy and elderly placing their faith in the gift of medicine were neglected, ignored and used for personal profit.”

Florida was a focal point of the takedown, with dozens of defendants charged across the state. The Tesar case stands out as one of the larger individual schemes and one in which nursing credentials are central to the allegations.

The Tesar indictment is the latest in a string of wound care and skin substitute fraud cases involving nurses and nurse practitioners — and federal investigators have said explicitly that more are coming.

Just last week, Nurse.org covered the indictment of Nevada NP Marizel Yukee, charged in a $906 million Medicare and TRICARE fraud scheme built on the same basic architecture: medically unnecessary amniotic wound allografts applied to elderly Medicare beneficiaries, many of whom were terminally ill in hospice care, with billing averaging over $1 million in claims per beneficiary.

In May, a Utah NP, RN, and podiatrist were indicted on 18 counts in a $29 million Medicare wound care case. Prosecutors alleged the defendants applied skin substitutes to patients who did not meet Medicare’s threshold requiring at least 30 days of basic wound care first, and continued treatment when it was no longer warranted.

The pattern reflects a broader enforcement surge. As Nurse.org reported in March, Medicare spending on skin substitutes skyrocketed from $256 million in 2019 to more than $10 billion in 2024, drawing sustained scrutiny from the DOJ’s Wound Care Initiative. Federal prosecutors have made clear there are more cases in the pipeline.

Wound care and skin-graft billing has become one of the most active areas of federal fraud enforcement, and this case is a pointed reminder that nurses and nurse practitioners are not insulated from criminal exposure when referral and billing arrangements cross legal lines. The allegations here center on kickbacks for referrals — an arrangement the federal Anti-Kickback Statute prohibits even when a clinician believes a patient genuinely needs care.

For working nurses, the practical takeaways are concrete: be cautious about any payment, bonus, or referral fee tied to sending patients toward a specific product, provider, or procedure, and document the clinical justification for treatments that draw high reimbursement. A nursing license can be suspended or revoked on the basis of fraud charges, and the reputational damage to the profession lands on everyone who wears the same credentials. If something in a workplace billing practice feels off, raising it through compliance channels is far safer than staying quiet.

It is also worth remembering that the patients described in these allegations were among the most vulnerable: people with infected or non-healing wounds, and some who were terminally ill. That is exactly the population nurses are trained to protect, which is part of why cases like this draw such scrutiny from federal investigators and from the profession itself.

Nurse.org will update this article as the case develops.

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