The Department of Justice announced on June 24, 2026 what it is calling the largest health care fraud enforcement action in American history — 455 defendants charged across 41 federal districts for allegedly defrauding Medicare, Medicaid, TRICARE, and other federal health programs of more than $6.5 billion. Among the defendants: a Sarasota, Florida nurse practitioner and two Tampa registered nurses tied to a single wound care scheme that allegedly billed Medicare for $118 million in fraudulent services.
The Florida wound care case is one of the larger individual schemes swept up in the national enforcement action. Federal prosecutors allege the scheme ran for years, generating Medicare payments of approximately $61 million before investigators intervened. Agents seized $11.8 million in assets connected to the alleged fraud.
The Florida Wound Care Defendants
Nurse practitioner Leigh Tesar of Sarasota faces federal charges related to her alleged role authorizing fraudulent wound care orders that Medicare would not have paid for under honest documentation. Co-defendants Walter Presha Jr. and Koby Evans, both registered nurses operating in the Tampa area, are charged with executing the scheme at the patient care level — allegedly providing or documenting treatments that either did not occur or did not meet the medical necessity criteria required for Medicare reimbursement.
Wound care is a high-value Medicare billing category. Complex wound treatment — including debridement, negative pressure wound therapy, biological skin substitutes, and hyperbaric oxygen — generates significantly higher reimbursement than routine nursing visits. Prosecutors allege the defendants exploited this billing premium by ordering and documenting services that were medically unnecessary, performed on patients who did not qualify, or simply never delivered.
Medicare paid approximately $61 million on claims submitted under the scheme before investigators identified the pattern. The remaining alleged $57 million represents claims that were submitted but not yet paid, or identified before payment through Medicare's pre-payment fraud detection systems.
What the 2026 Takedown Covers
This year's national enforcement action is the successor to annual DOJ health care fraud takedowns that have targeted different sectors in recent years. The 2026 sweep is distinguished by its scope — both in total defendants (455) and in alleged dollar volume ($6.5 billion). The prior record for a single health care fraud enforcement action was approximately $2.5 billion in alleged losses.
The cases announced June 24 span fraud categories including:
- Telemedicine schemes — companies paying physicians and nurse practitioners to sign orders for durable medical equipment, genetic testing, and medications without legitimate patient encounters
- Opioid and controlled substance diversion — prescribers and pharmacies charged with unlawfully distributing Schedule II and III narcotics
- Compounding pharmacy fraud — inflated billing to TRICARE and Medicare Part D for compounded drugs not medically indicated
- Home health and hospice fraud — billing for services to patients who did not qualify as homebound or terminal
- Wound care fraud — the category covering the Florida NP and nurses
The FBI, HHS Office of Inspector General, Drug Enforcement Administration, and state Medicaid Fraud Control Units coordinated on investigations that fed into the June 24 announcement. DOJ's Medicare Fraud Strike Force, which operates in the highest-fraud-risk metro areas, led many of the individual cases.
The NP and Nurse Exposure
Nurse practitioners occupy a particularly exposed position in health care fraud schemes because they sit at the intersection of clinical authority and billing eligibility. In states with full practice authority, NPs can independently order, document, and certify services that Medicare reimburses at physician rates. That clinical independence — a legitimate workforce development — also makes NP credentials valuable to scheme operators who need a licensed provider to sign off on orders.
The Tesar case fits a recurring pattern federal investigators call "order mills" — arrangements where a licensed prescriber signs large volumes of orders, often for patients they have never examined, in exchange for payments structured to avoid looking like kickbacks. Whether Tesar operated an independent practice or was recruited into an existing scheme is not yet clear from the charging documents.
For working nurses and NPs: participating in documentation that misrepresents what care was delivered — even when instructed to by an employer or billing company — is federal fraud. The "I was just following orders" defense has not protected front-line clinicians in prior DOJ health care fraud prosecutions. If documentation doesn't match care delivered, that is the moment to escalate to compliance or leave the job.
What Happens to Licenses
Federal criminal charges trigger an automatic review process at most state boards of nursing. Florida's Board of Nursing and the Florida Department of Health will separately evaluate whether Tesar, Presha, and Evans present an immediate danger to public health — a standard that can result in emergency suspension before any criminal conviction. Conviction on federal health care fraud charges typically results in permanent exclusion from Medicare and Medicaid participation, effectively ending a clinical career in any setting that accepts government payers.
The defendants are presumed innocent. Charges are allegations; the cases will proceed through the federal court system in the Middle District of Florida.
For Nurses: Red Flags in Your Workplace
The DOJ's annual health care fraud sweeps are not abstract enforcement news — they describe practice environments that real nurses were working in, often without recognizing the legal exposure. Common warning signs that a clinical setting may be operating a billing fraud scheme include:
- Pressure to document care that wasn't performed, or to use specific billing codes regardless of what the visit looked like
- Patients being referred to your facility in unusual volumes from a single source, particularly for the same high-value service category
- Compensation structures that pay bonuses tied to billing volume or specific procedure counts
- Management reluctance to let you review your own documentation or what was billed under your NPI
- Patients who express confusion about services they "received" that you have no record of providing
Reporting health care fraud — to the HHS OIG hotline (1-800-HHS-TIPS), to your state board, or to a whistleblower attorney — is protected activity under the False Claims Act. Nurses who report fraud in good faith cannot be legally retaliated against, and qui tam provisions allow whistleblowers to receive a share of recovered funds.