A physician from Frisco, Texas, has agreed to a $3.5 million settlement with the United States government to resolve allegations of submitting false claims under the False Claims Act. The announcement was made by Acting U.S. Attorney Jay R. Combs for the Eastern District of Texas.
Dr. Samad Khan, owner of SK Primary Care in Frisco, allegedly submitted false claims to the Health Resources & Services Administration's COVID-19 Uninsured Program. The program reimbursed providers for COVID-19 related services offered to uninsured individuals between May 2020 and April 2022.
The allegations state that from April 2020 through October 2021, Dr. Khan billed for evaluation and management (E/M) services that were not performed at his clinic’s COVID-19 testing sites in Texas. These sites were operated by SK Primary Care and its management company and were primarily walk-up or drive-through facilities.
According to the U.S., medical assistants conducted specimen collections using nasal swabs at these testing sites, yet claims were submitted under higher-level E/M service codes that require more complex medical decision-making typically provided by physicians or qualified health professionals (QHPs). It is alleged that patients did not receive E/M services from Dr. Khan or any other QHP either in person or via audiovisual means during their visits.
The submission of approximately 400,000 claims for higher-level E/M services allegedly occurred despite Dr. Khan knowing that the correct billing code was CPT Code 99211 for specimen collection—a less reimbursable service than higher-level E/M codes.
“The onset of the COVID-19 pandemic required both beneficiaries and the government to place their trust in front-line healthcare providers, even more than usual,” stated Jay R. Combs. “Unfortunately, some of those providers abused that trust and instead took advantage of the crisis to artificially inflate profits.”
Special Agent in Charge Jason E. Meadows added, “When health care professionals receive payments for false claims they submit to federal health care programs, they erode public trust and divert taxpayer-funded resources away from those who truly need them.”
The settlement is part of a coordinated effort involving multiple agencies including the Justice Department’s Civil Division and HHS-OIG among others. The resolution reflects allegations only without a determination of liability.
